Background: Age is a factor contributing to atherosclerosis. The elderly was shown to have a higher atherosclerosis incidence. But the studies in the hemodialysis patients were still limited. Objective: Through the examination of carotid intima-media thickness (CIMT), we investigated whether the atherosclerosis was more severe in the elderly than the non-elderly on regular hemodialysis. Methods: A cross-sectional study was conducted at our hemodialysis unit in Sanglah General Hospital from May to June 2016. All regular hemodialysis patients over 18 years old were recruited. But, patients with a malignancy, severe anemia, systemic lupus erythematosus (SLE), an acute infection, a liver function abnormality, a history of long-term steroid therapy, or patients who smoked tobacco were excluded. We examined the CIMT using a grayscale ultrasound. An independent t-test analysis was used to compare the CIMT means of the elderly and the non-elderly patients. Results: Our sample consisted of 30 elderly and 30 non-elderly hemodialysis patients. It was found that the CIMT mean in the elderly was significantly higher than in the non-elderly (0.73Â±0.1 mm versus 0.58Â±0.09 mm, p<0.001). Conclusion: More severe atherosclerosis was found in the regular hemodialysis patients in their late life.