Objective: Hypothyroidism, whether overt or subclinical, has multiple effects on the cardiovascular system. Neutrophil-lymphocyte (N/L) rate is closely related to cardiovascular disorders and atherosclerosis. Our study aimed to assess N/L rate and carotid artery intima-media thickness (CIMT) in patients with overt and subclinical hypothyroidism (SCH). Methods: The study included 36 patients with SCH and 28 patients with overt hypothyroidism (OH) as well as 30 healthy controls. CIMT, thyroid hormone levels, complete blood count and lipid parameters were measured in all subjects. Correlation analysis and linear regression analysis were performed for N/L rate. Results: Mean CIMT was 0.51 ± 0.15, 0.58 ± 0.16, 0.67 ± 0.24 mm in control, SCH, and OH groups, respectively. CIMT of OH patients was high compared with control subjects (P 0.05). It was no correlation that CIMT between N/L ratio (p > 0.05). Conclusion: Neutrophil-lymphocyte rate was not found to be useful indicator of early atherosclerosis in SCH and OH patients. J Clin Exp Invest 2013; 4 (4): 463-467