Objective：To investigate the predictive value of galectin-3（Gal-3）on carotid atherosclerosis（CAS）in middle-aged and elderly people. Methods：The general data and clinical biochemical indexes of 95 subjects who underwent physical examination in the community health service center of Nanchan temple in Wuxi from September 2017 to March 2018 were collected，and their Gal-3 level was detected. In December 2020，carotid artery ultrasound was used to assess carotid intima media thickness（cIMT）. The subjects were divided into 4 groups by the quartile method of Gal -3 level，and the characteristics of different groups were analyzed. The correlation between cIMT and clinical characteristics in all subjects and then particularly in patients who diagnosed with type 2 diabetes（T2DM）was explored，respectively. Finally，multiple linear regression analysis was used to explore the affecting factors of cIMT in T2DM patients. Results：Subjects with low Gal-3 level had corresponding lower fasting blood glucose（FBG）and glycated hemoglobin（HbA1c），as well as lower cIMT. Gal-3 was related with bilateral cIMT and found as affecting factor of CAS in patients with T2DM（P < 0.05）. Conclusion：Gal-3 is correlated with cIMT and has predictive value for the development of CAS in patients with T2DM.