Aim To evaluate the occurrence of carotid atherosclerosis in patients with rheumatoid arthritis (RA) by vascular echo tracking (ET) technique. Methods From January 2016 to May 7,0 RA patients (test group) in our hospital were selected, and 100 healthy persons for physical examination in the same period were selected as control group. Carotid elastic parameters, such as pressure-strain elastic modulus (Ep), stiffness parameter (β), one-point pulse wave velocity (PWV beta), augmentation index (AI) and arterial compliance (AC) were measured by vascular ET technology in the two groups. Carotid intima-media thickness (IMT) and plaque conditions were examined in the two groups. Results The indexes of Ep, β, PWVβ and AI in the test group were significantly higher than those in the control group, while the AC in the test group was significantly lower than that in the control group; The differences were statistically significant (P＜0.05). The carotid IMT in the test group was significantly higher than that in the control group (P＜0.05). The ratio of carotid atherosclerotic plaque in the test group (4.55%) was significantly higher than that in the control group (0.00%) (χ²＝4.656, P＝0.031). Conclusion Before the imaging features change of vascular wall morphology and structure, vascular ET technology can be used to evaluate the changes of carotid elasticity parameters in RA patients, which can reflect the condition of vascular elasticity and provide help for preventing carotid atherosclerosis in RA patients.