Aim To explore risk factors in the progression of carotid atherosclerosis, provide the basis for stroke prevention.Methods By random cluster sampling method, take the permanent residents aged 60 to 70 years in Renqiu as the targets. By taking face to face health questionnaire, anthropometric measurements, laboratory testing, vascular ultrasound examination of the neck, 5 010 cases are screened. Select 2 456 cases whose carotid ultrasound examinations showed plaques and stenosis for the study, observe their dynamic progression of stenosis and stenosis aggravating , and analyze risk factors of carotid atherosclerosis in progress.Results Within the 2 456 cases who prompted plaques and stenosis in carotid ultrasound in 2012, there were 223 cases which have suggestive carotid stenosis and stenosis aggravating in 2013 , among them, 123 cases were male （5.0%）, 100 cases were female （4.1%） Their associated risk factors as history of hypertension, diabetes mellitus, hyperlipidemia, cerebrovascular disease, smoking, passive smoking, excessive drinking, obesity, lack of physical exercise, atrial fibrillation, coronary heart disease, peripheral vascular, periodontal disease constituent ratio were 50.0%, 20.3%, 23.9%, 20.1%, 40.1%, 24.0%, 10.6%, 19.5%, 15.6%, 2.0%, 16.1%, 6.0%, 8.3%. Multivariate logistic regression analysis showed that smoking, systolic blood pressure, LDLC, cerebrovascular disease are independent risk factors in carotid atherosclerosis progression （P<0.05）.Conclusion One of the main causes of ischemic cerebrovascular disease is atherosclerotic carotid stenosis, and actively promoting smoking cessation campaign, effective control of blood pressure, LDL-C, especially those with a history of stroke population, can effectively control and reduce cerebrovascular disease occurring.