To discuss the relation between abdominal girths and carotid atherosclerosis among female patients that have high risk of stroke. Methods:A total of 1 228 women who have high risk of stroke that enrolled at Wangzuo and Puhuangyu community health service centers from May 2012 to February 2013 was selected. Then they were randomly divided into two groups according to their abdominal girths. The patients whose abdominal girths under 80 cm are the normal group, and the patients whose abdominal girths above 80 cm are the increasing group. To observe the thickness of carotid artery walls and the plaques of patients in both groups by conducting carotid artery ultrasonography. Results:Single factor analysis: comparing with the normal group, the increasing group has higher incidence of plaques and thicker carotid artery walls(P<0.01). The incidence of plaque and carotid intimal thickening is positively correlated with the increasing of abdominal girth(Spearman correlation coefficient are 0.140 and 0.169 respectively). Multifactor analysis: diabetes, increased abdominal girths, and smoking are related to the occurrence of carotid atherosclerosis. TCM symptom analysis: obesity, dark lips, head heaviness, and dry mouths are the symptoms that could induce carotid atherosclerosis(P<0.01 or P<0.05). Besides, the symptoms of phlegmdamp and bloodstasis present higher proportions in the increasing group(P<0.05). Conclusion:The increase of abdominal girth is positively related to the plaque and the thickness of carotid artery wall among women who have high risks of stroke. Therefore, they should conduct carotid artery ultrasonography. Comparing to other risk factors, diabetes and increasing abdominal girths are more likely to induce carotid atherosclerosis. Meanwhile, patients who have increased abdominal girths are more likely to develop phlegmdampness and bloodstasis symptoms.