Objective · To explore whether stiffness parameter β could help carotid intima-media thickness (IMT) to predict ischemic stroke. Methods · Ninety-nine patients with acute ischemic stroke and transient ischemic attacks were retrospectively evaluated by routine ultrasound and divided into increased IMT group and normal IMT group. The normal IMT group cases were further divided into 30～39 years, 40～49 years, 50～59 years and ≥60 years groups, and were compared with healthy crowd respectively. Results · ① The common carotid artery wall β of both increased IMT group and normal IMT group were significantly higher than healthy crowd (each P=0.000). ② Further analysis showed that β of ≥ 60 years group were significantly higher than healthy crowd (left side P=0.047, right side P=0.007); while the difference was not found across younger age groups (30～39 years, 40～49 years and 50～59 years). Conclusion · Stiffness parameter β may help carotid intima-media IMT to predict ischemic stroke in high risk subjects ≥ 60 years old without morphology changes.