Introduction: CAIMT measurement in hypothyroidism will help assess the progression of atherosclerosis and timely intervention may prevent vascular complications. Aim: The aim of our study was to assess the carotid artery intima media thickness (CAIMT) in patients with clinical and subclinical hypothyroidism and the effect of thyroid replacement therapy after 4 months on CAIMT. Materials and Method: This study included 30 clinical hypothyroid, 30 subclinical hypothyroid and 30 controls. As per procedure, informed consent was taken from the patients in prescribed formats before their participation in the study. Patients were divided into 3 groups of CH, SCH and Controls after obtaining the TFT values. CAIMT on the right side was measured in the three groups for comparison. Other parameters included age, sex, height, weight, BMI and lipid profile. After 4 months of levothyroxine therapy, CAIMT and lipid profile were reassessed. Results: The CAIMT was increased in CH and SCH group when compared to euthyroid individuals. The mean CAIMT in CH group was 0.60 ± 0.009 cm, in SCH group it was 0.055 ± 0.010 cm and in controls it was 0.047 ± 0.006 cm. After 4 months of levothyroxine therapy, there was no change observed in the mean CAIMT values. Conclusion: CAIMT levels are increased in CH and SCH group when compared to euthyroid controls. After 4 months of levothyroxine therapy there was no regression in CAIMT.