Background The relationship between parity and atherosclerosis has been reported in some ethnic populations.However,results re-garding Chinese women are still lacking.This study aimed to investigate the association of parity and carotid atherosclerosis,which has a predictive value of subsequent atherosclerotic events in elderly Chinese women.Methods A total of 2,052 participants from the medical examination center of the Third Xiangya Hospital were enrolled in the study.A standardized,structured questionnaire was administered to collect information on subjects'demographic characteristics,socioeconomic status,and cardiovascular risk factors.High-resolution ultra-sound was used to examine carotid plaques and carotid intima-media thickness(IMT).Results The mean age of participants was 66.1 ± 5.5 years.Women with more birth appeared to have a higher risk of carotid artery plaques.A multivariate-adjusted model yielded an odds ratio of 1.38(95％CI:12％-70％,P = 0.003)per birth.A positive association was observed between parity and common carotid IMT(β ± SE:0.029 ± 0.006,P ＜ 0.001),and internal carotid IMT(β ± SE:0.011 ± 0.005,P = 0.03)in a univariate model;however,these associations became non-significant in multivariate-adjusted models.When common carotid IMT was classified into an IMT ≥ 1 mm group and an IMT＜ 1 mm group,higher parity was associated with more obvious thickening both in the unadjusted model(OR = 1.61,95％CI:1.29-2.00,P ＜0.001)and in the fully adjusted model(OR = 1.43,95％CI:1.09-1.88,P = 0.01).Conclusions There is a positive association between parity and risk of carotid plaques,as well as between parity and risk of obvious thickening for common carotid IMT in elderly Chinese women,indicating multiparous women might experience more atherosclerotic challenges.