One hundred and thirty-eight male subjects working as civil servants in the Catanzaro city hall, aged over 45, underwent Echo-Doppler examination of carotid and femoral arteries. Forty-one subjects (30%) presented evidence of early atherosclerotic lesions in at least 1 of the 10 examined arteries. Age, systolic blood pressure, serum triglycerides and serum glucose were higher in this group when compared with subjects without evidence of extracoronary atherosclerosis (EA), while HDL cholesterol and apolipoprotein A-I were lower. After adjustment for age, only serum triglycerides and apolipoprotein A-I levels remained significantly different. Only 21 subjects had no major coronary heart disease (CHD) risk factors, 46 had one, 47 two and 24 more than two risk factors. The prevalence of lesions was significantly higher in individuals with total cholesterol/HDL cholesterol ratio greater than 5. The presence of smoking and hypertension was almost equally represented in individuals with or without lesions. Serum triglycerides, total cholesterol/HDL cholesterol > 5 and apolipoprotein A-I seem to play a fundamental role in the development of EA, as detected by Duplex examination of carotid and femoral arteries. Age is also closely related to the presence of lesions, probably reflecting the exposure duration to CHD risk factors.