BACKGROUND: Recent studies have confirmed inflammatory factors and metabolic syndrome (MetS) as important cardiovascular disease (CVD) risk factors. Recently measurement of carotid intima-media thickness (IMT) has been used for evaluation of early atherosclerosis. This study was designed to assess the correlation between IMT with some inflammatory biomarkers, ghrelin and adiponectin in people with and without MetS in a cohort sample in Isfahan province. METHODS: Among participants of Isfahan Cohort Study (ICS) by random sampling, ۸۸ participants were selected and divided into case (with MetS) and control (without MetS) groups. A questionnaire including demographic data and CVD risk factors was completed for all of the participants. Physical examination and blood pressure, height, weight and waist circumference measurements were done for all subjects. Vascular echocardiography was done for evaluation of IMT of each carotid artery of both sides. Interlukin-۶ (IL-۶), interlukin-۱۰ (IL-۱۰), highly sensitive C-reactive protein (hs-CRP), ghrelin and adiponectin levels were measured using ELIZA method. Data were entered in SPSS version ۱۵ and analyzed by t test, chi square, Pearson correlation and linear regression analyze. RESULTS: The mean waist circumference, BMI, systolic blood pressure, diastolic blood pressure, hs –CRP and IMT of left carotid artery were significantly higher in participants with Mets. There was significant correlation between left carotid IMT and IL-۶ level in all patients (P=۰.۰۳). After adjustment for age and sex, significant relationship in groups with MetS was only reported between the left IMT and IL-۶ (P=۰.۰۲). There was no relation between IMT and other inflammatory markers in subjects with and without MetS. CONCLUSION: Significant correlation between IL-۶ and IMT was reported in patients with MetS. While no significant correlation between IL-۱۰, adiponectin and ghrelin with IMT was observed in metabolic syndrome group. Keywords: Intima-media thickness (IMT), carotid artery, hs-CRP, Ghrelin, Adiponectin IL-۶, IL-۱۰.