Objective: The effects of hormone replacement therapy (HRT) in the natural menopausal period have been extensively Studied. However, these effects have almost none been studied in purely Surgical menopause. The aim of this study was to measure intima-media thickness (IMT) of carotid arteries bilaterally in two groups of surgical menopausal women who received HRT versus who did not. Methods: A B-mode ultrasound Unit was used for the measurements of the IMTs of carotid arteries in two groups. Measurements of Group 1 (n = 65. untreated group) were compared with those of Group 2 (n = 70, treated group), in 2-years of follow-up. Patients in Group 2 received daily doses of 0.625 mg of oral conjugated estrogen preparates. Serum estradiol levels, lipid profiles, and blood pressures were measured, pre and postoperatively. For the statistical analyses in terms of differences of IMTs between two groups, general factorial analysis of variation was used. Results: Among preoperative values of low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol, systolic and diastolic blood pressures. estradiol, and age, only the estradiol values showed significant difference between both groups. The statistical results concerning the postoperative IMT differences for both groups showed that there was a statistically significant difference when comparing both groups. showing an increase in IMT in Group 1. Conclusion: In surgical menopausal women, the direction of the HRT effect is in agreement with evidence from earlier studies on the effects of HRT in natural menopausal women. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.