This study investigated expression of markers of subclinical atherosclerosis (ATS) in IBD. Both IMT and arterial stiffness parameters (PWV and AIx) are increased in IBD patients. Markers of ATS are significantly increased in patients on 5-ASA therapy only. Therapies able to obtain a full control of inflammation may reverse also ATS risk in IBD. Longitudinal studies are needed to confirm the correlation between ATS markers, inflammation and drug options in IBD.