The objective of this study was to determine the degree of vascular atherosclerotic damage at the carotid and femoral levels in a group of subjects over sixty years old practicing endurance sports. Using high-resolution Doppler-color flow ultrasonography the authors carried out a vascular screening, comparing two distinct groups of subjects, the first consisting of 20 elderly male subjects (age 65.6 +/- 5.6 years) practicing endurance sports (runners) and the second of 20 subjects of the same gender and age (63.5 +/- 4.5 years), clinically healthy, but leading a sedentary life. All subjects were nonsmokers, nondiabetics, with normal lipid values and normal blood pressure. The authors examined the internal, external, and common carotid arteries, bilaterally, as well as the common femoral, deep femoral, and superficial femoral arteries of both legs. For each vessel they documented: (1) presence of plaques, (2) position and quantity of the plaques, (3) stenosis percentage produced by the plaques, (4) echographic structure of the plaques. In the group of sportsmen they calculated a global score of atherosclerotic damage of 5.58 +/- 2.21. This is statistically significant (P < 0.001) as compared with the global score observed in the sedentary group (9.24 +/- 3.9, range 6-14). The sportsmen exhibited small atherosclerotic plaques that were not hemodynamically significant; these plaques were present in 7 subjects (35%). In 4 of them (20%) the lesions were located in one carotid artery system. In the other 3 subjects (15%) the lesions were identified in one femoral artery system. In none of the sportsmen were they able to demonstrate simultaneous atherosclerosis of carotid and femoral arteries. In the sedentary subjects, atherosclerotic lesions were identified in 15 of them (75%). In 2 subjects hemodynamically significant plaques were located in one carotid artery system. In the other 13 subjects the plaques found were not hemodynamically significant; in 6 subjects this type of lesion was present in both femoral and carotid arteries; in 5 the lesions were located in one carotid artery system, and in 2 in one femoral artery system. In conclusion, endurance exercise appears to protect the elderly against atherosclerotic vascular damage.