Background: Migraine is associated with atherosclerosis and white matter hyperintensities. This study aims to evaluate the relationship between white matter hyperintensities and carotid intima-media thickness in patients who have migraines without auras. Methods: The study enrolled 105 patients; of these, 43 patients had migraine without white matter hyperintensity (WMH) and 32 had migraine with WMH. There were also 30 healthy control subjects. The patients were divided into two groups according to whether or not they had WMHs on their brain magnetic resonance imaging (MRI). All subjects, including the control group, underwent brain MRI and carotid ultrasonographic examination to evaluate WMH and carotid intima-media thickness (CIMT), respectively. Results: The groups did not differ with regard to demographics and clinical findings. The CIMT was significantly greater in patients who had migraine without WMH than in the control group (p < 0.001) and in those who had migraine with WMH than in those who had migraine without WMH (p = 0.004) Conclusion: CIMT values were higher in migraine patients with WMH than in migraine patients without WMH. Migraine patients with WMH may be at a greater risk of developing future vascular events.