Background: Resistin is a small protein that has pro-inflammatory and atherogenic effects. This study aimed to evaluate the level of serum resistin as a marker of subclinical atherosclerosis in multiple sclerosis (MS) sufferers. 114 MS sufferers and 114 age, sex and body mass index matched controls were enrolled in this study, subjected to detailed history taking, general, neurological examination, assessment of anthropometric measurements, serum resistin level, and carotid duplex to asses subclinical atherosclerosis. Results: MS sufferers showed a higher cholesterol, and triglycerides levels as compared to controls. Progressive MS sufferers (SPMS, and PPMS) showed a higher cholesterol level as compared to RRMS sufferers. SPMS sufferers showed a higher cholesterol level as compared to PPMS sufferers. RRMS sufferers showed a higher triglycerides level as compared to progressive MS sufferers. Sufferers had significantly higher mean levels of resistin and right carotid intimal medial thickness (CIMT) as compared to controls. There was a significant positive correlation in MS sufferers between serum resistin and the following parameters: age, and disease duration, body mass index, triglycerides, cholesterol and low-density lipoprotein. There were significant positive correlations between carotid intimal medial thickness and body mass index, disease duration, age, expanded disability status scale, levels of triglycerides, low-density lipoprotein, and cholesterol. The risk factors of subclinical atherosclerosis in MS sufferers were higher mean levels of resistin, triglycerides, low-density lipoprotein, cholesterol, and disease duration. Subclinical atherosclerosis in MS sufferers was significantly associated with higher mean levels of resistin, and triglycerides. Conclusions: Higher mean levels of resistin might reflect the predisposition to subclinical atherosclerosis in MS sufferers.