Background: Stroke is a leading cause of neurological disability and death in adults. Carotid atherosclerosis represents major aetiopathogenesis of stroke. Ultrasonography is affordable, safe and relatively available imaging modality. The aim of this study was to determine the intima-media thickness (IMT) of common carotid arteries (CCA) in adult stroke patients in Maiduguri, North-Eastern Nigeria. Materials and Methods: This was a cross-sectional prospective study carried out on 100 adult stroke patients that attended neurology clinic and wards at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria. All patients had neuroimaging (Brain CT/MRI) for confirmation of diagnosis. The examination was performed using Logic P5 GE ultrasound scanner equipped with linear transducer. The IMT of CCA of the patients was measured using grey scale ultrasonography and was correlated with age and sex. Results: There were 62 males and 38 females aged 30-85 years (mean ± SD of 59.15 ± 4.20 years). Ischaemic stroke was the major subtype of stroke (73% of the study population). The overall mean CCA IMT was 1.03 ± 0.29 mm. Forty five percent (45%) of the stroke patients had increased CCA IMT (>1.0 mm). The relationship between increased CCA IMT with stroke was statistically significant (p = 0.02). There was significant correlation between increased CCA IMT with increasing age (p = 0.01). However, the IMT was higher in men than the women but their correlation was not statistically significant. Conclusion: Increased CIMT was significantly associated with stroke. There was positive correlation between increased CIMT with advancing age