Aim To evaluate the predictive value of low density lipoprotein subfractions detected by lipoprint method for carotid artery intima-media thickness (CA-IMT). Methods A retrospective analysis of 175 patients in the department of cardiology of our hospital, the average age was 67 years, including 106 males (60.6%) and 69 females (39.4%). In all patients lipoprint lipoprotein classification detection system was used for low density lipoprotein(LDL) subfractions of cholesterol and four types of blood lipids, the color Doppler ultrasound detector was used to measure the thickness of the carotid artery intima-media, the differences in blood lipid levels and CA-IMT between groups under traditional risk factors were compared. Linear correlation analysis was used to evaluate the relationship between CA-IMT and traditional risk factors and low-density lipoprotein subfractions. Logistic regression analysis was used to evaluate the predictive value of low-density lipoprotein subfractions in CA-IMT. Results Compared with males, the LDL4 level was lower in female patients (P<0.05), and the CA-IMT was lower than that in males (P<0.01). The small, dense low-density lipoprotein(sdLDL), subfractions and CA-IMT of patients with traditional risk factors such as hypertension and diabetes were higher than the normal group, but the difference was not statistically significant (P>0.05). Correlation analysis showed that CA-IMT was negatively correlated with gender (P<0.05), and positively correlated with total cholesterol (TC), LDL and non high density lipoprotein (non-HDL) (P<0.05)； and it was positively correlatied with sdLDL, low-density lipoprotein subfractions LDL3, LDL4 (P<0.01). CA-IMT was also positively correlated with traditional risk factors smoking (P<0.05). Logistic regression analysis showed that LDL, sdLDL and sdLDL subfractions LDL3 and LDL4 were independent predictors of CA-IMT thickening. Conclusion Small, dense low-density lipoprotein and its subfractions have a correlation with CA-IMT and have predictive value for atherosclerosis.