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Introduction The aim of this study was to evaluate 3-dimensional (3D) ultrasonography (US) in determining the surface irregularity of carotid artery plaques. Material and methods This study included 50 patients (20 females and 30 males) aged between 56 and 82 years with plaques in the carotid artery which were detected during routine neck ultrasound. Simultaneously these cases were evaluated in terms of plaque echogenicities and surface characteristics with 2D and 3D US. Results 3D imaging was successfully performed in 45 of the 50 case