Background and Purpose: High-sensitivity C-reactive protein ( hs-CRP) is a risk indicator for atherosclerosis. However, the association between hs- CRP and early carotid atherosclerosis progression is not well established. We undertook a prospective, community-based, observational study to address this question. Methods: Common carotid artery intima-media thickness (IMT) and hs-CRP values were measured at baseline and after 2 years of follow-up in subjects >= 40 years of age who were participating in the Asymptomatic Polyvascular Abnormalities Community study. Association between hs-CRP values and IMT progression was determined before and after controlling for vascular risk factors. Results: IMT was measured in a total of 1918 subjects at baseline and 52.97% of those (1016 of 1918) had IMT progression after 2 years. No significant association between progression of IMT over a 2-year period and average hs-CRP levels was found (multivariate-adjusted, P for trend =.280). Both hs-CRP values measured at baseline (P =.836) and after 2 years of follow-up (P =.440) were not associated with IMT progression levels. Average hs-CRP values were not related to IMT progression levels in a dose-response manner (P =.784). In a subgroup analysis stratified by age and sex, hs-CRP values were also not significantly associated with IMT progression levels (P >.05). Conclusion: Our results suggest that hs-CRP is not a predictor for the progression of early atherosclerotic changes of the carotid arteries. The hsCRP levels in early atherosclerosis might be considered as risk markers rather than having a causal role.