Despite enormous progress made in cardiovascular prevention and treatment, sudden death remains the first manifestation of ischemic heart disease for too many subjects. A better individual cardiovascular risk assessment would definitely help select the most efficacious interventions allowing to prevent the development of atherosclerosis and its complications. Risk scores, although not used as frequently as expected in everyday practice are a first step towards helping decision making to reduce cardiovascular diseases. The use of vascular markers for early atherosclerosis detection should be even more profitable to reduce CV diseases. Pulse wave velocity, intima-media thickness and ankle brachial index measurements are among the most simple and promising markers of early vascular disease are discussed briefly in this paper.