Introduction: Pathophysiology of the aorta negatively impacts cardiovascular health. Hypothesis: Assessment of aortic anatomy facilitates population-based cardiovascular disease (CVD) risk stratification. Methods: Framingham Heart Study Offspring Cohort participants without prevalent CVD (n=1576, 64±9 years, 44% men) underwent 1.5T ECG-gated axial T2W black-blood CMR of the thoracoabdominal aorta (2002-2006). The diameters of the descending thoracic and proximal and distal abdominal aorta (infrarenal and aortic bifurcation) were measured ( Figure A ). Additionally, the maximum diameter and the total intravascular volume of the descending thoracic and abdominal aorta were calculated. Cox proportional hazards regression analyses adjusting for age, gender, systolic blood pressure, total cholesterol/HDL cholesterol ratio, diabetes mellitus, smoking, as well as treatment for hyperlipidemia, hypertension, and diabetes were undertaken to evaluate the association of aortic anatomy with incident CVD ( Figure ). Results: During follow-up (median 9.5 years, range 0 - 12.2 yrs), 163 incident CVD events occurred, of which 66 were major events (myocardial infarction, ischemic stroke, and CVD death). In multivariable-adjusted Cox regression models, each SD unit greater descending thoracic and maximum aortic diameter, as well as natural logarithmic transformed total aortic volume were associated with a >20% increased risk for incident CVD (per SD Unit hazard ratio [HR]: 1.21, 95% CI: 1.03-1.42, P=0.019; HR 1.22, 95% CI: 1.04-1.43, P=0.014; HR: 1.24, 95% CI: 1.10-1.39, P<0.001, respectively; Figure B ). Abdominal aortic diameters were not associated with CVD. Conclusions: In this middle-aged community-dwelling Caucasian adult cohort followed over 10 years, greater thoracoabdominal aortic dimensions and volume, predicted incident CVD. Future investigations may determine the implications of aortic size modification on CVD outcomes.