Objective To evaluate whether waist circumference (WC) 〉85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China. Methods A total of 2365 females aged 〉20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness (C-iMT) was measured. Results The C-IMT was significantly higher in overweight or obese women with their BMI 〉25.0 kg/m2 {P〈O.01) and in those with their WC _〉85 cm than in those with their WC 〈85 cm (P〈O.01). Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC 〈 85 cm (P〈O.01) while no significant tendency was found in the subgroup with its WC_〉85 cm (P=0.07). Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC _〉80 cm, _〉80 cm and 〈85 cm and 〉85 cm for evaluating the risk of C-IMT elevation was 2.632, 2.501, and 1.878, respectively. Conclusion WC is significantly correlated with C-IMT in women from Shanghai, China, and WC_〉85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.