Background: Cardiovascular disease is the main cause of mortality after renal transplantation. Soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and fibroblast growth factor-23 (FGF-23) are two novel molecules that have been associated with atherosclerosis in different populations. In this cross-sectional study, we investigated the associations between sTWEAK, FGF-23, and carotid artery intima-media thickness (CA-IMT) in renal transplant patients. Methods: A total of 117 renal transplant patients were studied. CA-IMT was determined by B-mode Doppler ultrasonography. Serum sTWEAK and FGF-23 were measured by a commercially available enzyme-linked immunosorbent assay (ELISA). Results: Mean age was 39.6 +/- 9.6 years and 51% of the patients were male. Mean sTWEAK level was 595 +/- 225 pg/mL (158-1140), FGF-23 level was 92 +/- 123 RU/mL (9.6-1006), and CA-IMT level was 0.62 +/- 0.11 mm (0.40-0.98). sTWEAK level was positively correlated with CA-IMT. There was no association between sTWEAK and FGF-23 levels. FGF-23 was also associated with CA-IMT. In adjusted models using linear regression analysis, only age and serum TWEAK levels were predictors for CA-IMT. Conclusion: There is a positive correlation between CA-IMT and sTWEAK, but not with FGF-23 levels in renal transplant patients.