Background: Cardiovascular diseases are the most important causes of mortality and morbidity in CKD mainly due to accelerated atherosclerosis. Mg2+ possesses an anti-atherosclerotic effect, because of its anti-inflammatory and antioxidant properties, by inhibiting endothelial proliferation and inhibiting the upregulation of PAI 1 and VCAM 1. Mg2+ deficiency promotes hydroxyapatite formation and calcification of VSMC thus leading to accelerated plaque formation. Aim and objectives of current study were to evaluate relationship between serum Mg2+ level and atherosclerotic changes in patients with CKD. Methods: This hospital based observational cross-sectional study has been carried out in department of KPS institute of medicine, GSVM Medical College, Kanpur. 58 subjects were recruited and underwent routine tests including Serum urea, creatinine, calcium, phosphorus, iPTH, Magnesium and intima media thickness (IMT) of carotid artery via Doppler study. Results: In our study the mean value of Mg2+ was 2.25 mg/dl±0.81 17 out of 58 patients (29.3%) had hypomagnesemia. Intima Media thickness of carotid artery had an observed mean value of 1.0 cm±0.24, with mostly increased in those who had hypomagnesemia. Serum Mg2+ was negatively correlated (Pearson correlation coefficient was -0.677 and -0.704) with CIMT with statistical significance as p<0.001. Also, our study revealed no significant correlation between serum Mg2+ and other laboratory data (Ca2+, P, iPTH, urea and creatinine. Conclusions: We concluded that serum Mg2+ may be considered as a modifiable risk factor of atherosclerosis (thus, cardiovascular mortality) in CKD patients.