The causes for falls in the elderly are varied, and visual spatial neglect could be 1 contributing factor. Further, the presence of a carotid artery plaque, especially on the right side, might influence the visual spatial attention of the elderly.Our aim was to identify the intrinsic association between carotid plaques and lateralization of spatial attention in the elderly. Further, we sought to understand and potentially prevent the consequences of unilateral spatial neglect such as injury from falls.Participants aged 64 to 93 years were divided into a group with carotid artery plaque(s) of the right side or both sides (BOTH, n = 38; and 9/ 38 were right side only) and a group without right-side carotid artery plaque(s) (LEFT, n = 53). Participants were asked to perform a line bisection task and undergo doppler ultrasonography examinations.Contrary to expectations, compared to LEFT, the mean index and net scores of the line bisection errors in BOTH were significantly less leftward, but the mean diameter of the right-side common carotid artery in BOTH was significantly larger.Our results indicate that the presence of carotid plaque(s) might be linked to increased risk of falls in the elderly. The attenuated spatial neglect in participants with right-side carotid artery plaque(s) might be due to compensatory carotid artery dilatation.