Background: We aimed to investigate whether non-alcoholic fatty pancreas disease (NAFPD) is associated with epicardial adipose tissue (EAT), which is a kind of ectopic fat accumulation, and aortic intima-media thickness (aIMT), which is associated with subclinical atherosclerosis. Methods: Fifty-four patients with NAFPD (22men;mean age: 52  10 years) and 49 without NAFPD (16men;mean age: 49  8 years) were included in this study. NAFPD and aIMT were evaluated using transabdominal ultrasonography (TUS). EAT was evaluated with transthoracic echocardiography. Results: EAT (6.09  1.52 mm and 3.87  1.31 mm, p < 0.001) and aIMT [1.12 (0.60-1.90) mm vs. 0.93 (0.50-1.44) mm, p < 0.001] were significantly higher in the NAFPD positive subjects, compared to the NAFPD negative subjects. Multivariate analysis showed that age (p = 0.016), bodymass index (p = 0.004), and presence of NAFPD (p = 0.024) were associated with increased aIMT. In addition,multivariate analysis demonstrated that the presence of NAFPD (p < 0.001) was associated with increased EAT. Conclusions: The presence of NAFPD on TUS is associated with increased aIMT and EAT. Our study results may suggest that NAFPD may reflect subclinical atherosclerosis and may be a simple warning sign for physicians.