This study investigated the long-term effects of socioeconomic status (SES) on atherosclerosis.Data from the Epidemiology of Hearing Loss Study and the Beaver Dam Eye Study (Beaver Dam, WI, 1998–2000), were used to examine adult SES (education, household income, and longest-held job) and childhood SES (household density and parental home ownership at age 13) associations with carotid intima-media thickness (IMT) and carotid plaque in a cohort of 2042 men and women aged 53 to 94years.For education, income, and occupation (women), those in the lowest SES group had statistically larger age-sex-adjusted IMT than those in the highest SES group (<12 vs. >12years education: 0.92 vs. 0.86mm respectively, P<0.0001), (<$10,000 vs. >$45,000: 0.97 vs. 0.87mm, P<0.0001), (operator/fabricator/labor vs. manager/professional: 0.89 vs. 0.82mm, P<0.001). Associations were similar using carotid plaque as the outcome. Participants with low levels of both adult and childhood SES measures had age-sex-adjusted IMT greater than those with persistently high levels of SES (0.93 vs. 0.84mm, P<0.0001).Measures of SES at two points in the life-span were associated with subclinical atherosclerosis.