Objective: Vascular impairment in patients with Beta-thalassemia major (BTM) is an extremely clinically relevant issue, associated with a high risk of accelerated atherosclerosis. Beta-stiffness index (BSI) is an echo-tracking parameter that can reveal increased carotid stiffness. To examine the beta-steffness index in patients with BTM and healthy controls. To analyze parameters of lipid metabolism and atherogenic lipid indices (Castelli Risk Index I, CRI-I, Castelli Risk Index II, CRI-II, Atherogenic index of plasma, AIP, Atherogenic coefficient, as a marker of cardiovascular risk in BTM patients compared with healthy controls and to find out correlations between the BSI and atherogenic lipid indices in patients with BTM. Design and method: 38 children and young patients with BTM (mean age 25.0±10.8 years, 20 female) and 40 healthy controls (mean age 23.1±11.0 years, 20 female). All subjects underwent carotid examination of beta-stiffness index by echo-tracking method with Aloka Hitachi prosound alfa 7, 7.5-MHz linear array of the right and left common carotid arteries about 1 cm proximal to the bulb. Blood test samples for lipid parameters – total cholesterol (TC), LDL, HDL, triglicerides (TG) were performed as well as calculations of the atherogenic lipid indices. Results: The mean AIP values in patients were 0.17±0.30 and in health controls -0,34±0.19, p=0.0001. The Castelli Risk index I in patients was 3.64±1.19 and in healthy controls was 2,75±0.74 (p=0.0001) –tabl.1. There was positive correlation between beta-stiffness index of both carotid arteries and some lipid parameters – tabl.2. Conclusions: Young adults with BTM are at increased risk of atherosclerosis and the subclinical impairment can be easily detected by methods of carotid ultrasound examination using beta-stiffness index and by atherogenic lipid indices.