ObjectiveTo assess the relationship between alcoholic fatty liver disease (AFLD) and carotid intima-media thickness (CIMT) and the influencing factors for CIMT. MethodsA cross-sectional study was conducted in 147 males who were inpatients or had physical examination at the Taishan Hospital in Shandong Province during January 2012 to December 2013. The participants, including 136 drinking cases and 11 non-drinking cases, were divided into mild AFLD group (A, 45 cases), moderate to severe AFLD group (B, 58 cases), and non-AFLD group (C, 44 cases). Comparison of mean values between groups was performed using one-way ANOVA, and pairwise comparisons were performed using the LSD test (for homogeneity of variance) or Tamhane's test (for heterogeneity of variance). Results(1) CIMT was significantly higher in group B than in group C (P=0.001). (2) BMI was significantly higher in group A than in group C (P=0.029). Total cholesterol, triglyceride, very-low-density lipoprotein, apolipoprotein B, and uric acid levels significantly rose in groups A and B compared with group C (P＜0.05). (3) Gamma-glutamyl transpeptidase (GGT) level was significantly higher in group A than in group C (P=0001), whereas alanine transaminase, aspartate aminotransferase, and GGT levels were significantly higher in group B than in group C (P=0.023, 0.003, and 0.000, respectively). (4) Serum creatinine level was significantly lower in groups A and B than in group C (P=0007 and 0.005, respectively). ConclusionAFLD can cause the increase in CIMT, resulting in metabolic syndrome-like changes and liver/kidney dysfunction. With increasing severity of AFLD, CIMT increase becomes more significant. Thus, AFLD can be used as an indicator for predicting CIMT increase in human population.