Abstract: Objective To investigate the relationship between body mass index (BMI) and carotid plaque in population at high risk for stroke. Methods The clinical data of 546 cases at high risk for stroke in our hospital were analyzed. Color Doppler was used to examine the number of carotid plaque. The correlation between BMI level combined with other risk factors and carotid plaque. Results High BMI was the independent risk factor for carotid plaque formation (OR=1.653, 95% CI:1.063~2.572, P=0.026). The formation rates of carotid plaque in overweight and obesity groups with risk factors for stroke, including age and hypertension, and diabetes group were all higher than that in control group (all P0.05). Especially, the formation rate of carotid plaque in group complicated with hypertension were 2.270, 3.167 and 3.647 times higher than those in control group respectively (all P0.01). Conclusion Elevated BMI is associated with carotid plaque formation, especially in those complicated with hypertension, dysglycemia, at risk age and with other risk factors.