Background: Carotid intima-media thickness (cIMT) is one of the markers for atherosclerosis associated with the risk of stroke. Dietary fat intake is a risk factor for both atherosclerosis and stroke. Correlation of dietaryfat intake in post ischemic stroke patients with changes in cIMT has not been widely published. Aim: To analyze correlation between dietary fat intake and changes in cIMT in post ischemic stroke patients. Method: This is a prospective cohort study conducted in neurology clinic, Dr. Kariadi General Hospital, Semarang. Subjects were60 post ischemic stroke patients. cIMT was examined at baseline with a 6 month follow up period. The intake of fat (total fat), Saturated Fatty Acids (SFA), Monounsaturated Fatty Acids (MUFA) and polyunsaturated fatty acids daily (PUFA) was measured using semi quantitative Food Frequency Questionnaire. Demographic data and risk factors for stroke were documented during recruitment of subjects. Examination ofblood pressure, serum lipid profile (total cholesterol, LDL-C, HDL-C, TG), GD I, GD II, and HbA1c were also performed at baseline with a 6 month follow-up period. The relationship between dietary fat intake and progression of cIMT were analyzed using correlation, Pearson Chi-square, Fisher, and logistic regression. The analysis was significant if the p value <0.05. Result: The mean age of subjects was 61.2 +/- 8.2 years, 61.6% were male, with a mean BMI of 22.3 +/- 2.2 kg / m(2). Total daily dietary fat intake of > 30% of total energy was found in 58.3% of subjects. SFA intake of >10% of total energy was found in 71.7% of subjects. PUFA intake <6% of total energy was found in 61.7% of subjects. There is an increase in mean of cIMT thickness over 6 months, with mean of cIMT at baseline was 0.73 +/- 0.24 mm and was increased to 0.82 +/- 0.25 mm at 6 months follow-up. Total fat intake was positively correlated with Delta cIMT (r = 0.661, p = <0.001). While the dietary intake of PUFA negatively correlated with Delta cIMT (r = -0.859, p = <0.001). Conclusion: There is a positive correlation between total daily dietary fat intake and changes in cIMT. The intake of PUFA is negatively correlated with the changes in cIMT. People with total daily fat intake> 30% of total energy had 6.17 times higher risk for an increase of cIMT> 0.1 mm in 6 months. The intake of polyunsaturated fatty acids daily (PUFA) <6% of total energy had 8.92 times the risk of increased cIMT> 0.1 mm in 6 months.