To study the correlation between glycosylated hemoglobin (HbA1c) level and carotid intimamedia thickness (CIMT) thickening in general physical examination population. Methods A total of 9 881 cases with general physical examination were selected as the research object, including 7 091 males and 2 790 females. CIMT was measured by vascular color Doppler ultrasound. According to whether there was CIMT thickening, the cases were divided into the thickening group (4 513 cases) and the normal group (5 368 cases). The general data and laboratory data of the two groups were collected and compared. Logistic regression was used to analyze the risk factors of CIMT thickening in the general population and different genders. Receiver operating characteristic curve (ROC) was used to evaluate the predictive effect of the HbA1c level on CIMT thickening. Results Compared to the normal group, male proportion, age, body mass index (BMI), systolic blood pressure (SBP), direct bilirubin (DBIL), globulin (GLB), blood urea nitrogen (BUN), blood creatinine (Scr), blood glucose (GLU), HbA1c, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels were increased in the thickening group. The glomerular filtration rate (eGFR), alanine aminotransferase (ALT), albumin (ALB) and high density lipoprotein cholesterol (HDL-C) were decreased (P<0.05). Logistic regression analysis showed that in the total population, advanced age, male, ALB, GLU and LDL-C increased, and HbA1c≥5.7% was risk factors for CIMT thickening, while increased GLB and HDL-C were protective factors for CIMT thickening. In males, advanced age, increased ALB and LDL-C, and HbA1c≥5.7% were risk factors for CIMT thickening, while increased ALT, GLB and HDL-C were protective factors for CIMT thickening. In females, increased SBP and TC and HbA1c≥5.6% were risk factors for CIMT thickening, while increased BMI, eGFR, ALB, Scr and HDL-C were protective factors for CIMT thickening. ROC curve analysis showed that the optimal cut-off value of HbA1c in predicting CIMT thickening was 5.65% in the total population, males and females, and HbA1c has better predictive efficiency for CIMT thickening in females. Conclusion The elevated HbA1c levels are a risk factor for CIMT thickening in the general population, and HbA1c has a greater effect on CIMT thickening in the females. [ABSTRACT FROM AUTHOR]