Atherosclerosis is the main cause of cardiovascular diseases, while Carotid intima-media thickness is a biomarker of subclinical atherosclerosis. Numerous studies have confirmed that exercise can slow down or even reverse the formation and progression of carotid Intima-Media thickness. This paper provides a review of the effects of different exercise modalities, intensities, and populations on the vascular structure to provide a reference for the prevention of atherosclerosis with exercise.