Objective: Depression and coronary heart disease are often comorbid conditions, but the mechanism behind this link is largely unknown. We tested the hypothesis that a high level of depressive Symptoms in healthy young adults would be related to more prevalent preclinical atherosclerosis. Methods: We studied the association between depressive symptoms and carotid atherosclerosis in 1126 young adults (4 10 men and 716 women) as part of the ongoing population-based Cardiovascular Risk in Young Finns Study. The participants responded to a revised version of Beek's Depression Inventory in 1992, 1997, and 2001. Carotid atherosclerosis was assessed by measuring the thickness of the common carotid artery intima-media complex with ultrasound in 2001. Cardiovascular risk factors were measured in childhood/adolescence (1980) and in adulthood (2001). Results: In men, high scorers of depressive symptoms in 2001 had higher carotid artery intima-media thickness (0.63 mm) compared with those with low or moderate scores on depressive symptoms (0.57 mm). This relationship (B = 0.08, F[1,405] = 9.24, p = .003) persisted after adjustment for age and cardiovascular risk factors in adolescence and adulthood. Depression scores in 1992 and 1997 were not predictive of intima-media thickness. In women, no association was found between depressive symptoms and intima-media thickness. Conclusions: Depressive symptoms during early adulthood seem to be associated with higher levels of carotid intima-media thickness in men, but not in women.