Background: Diabetes and hypertension are related to cardiovascular risk factors and are possible to detect development of atherosclerosis in cardiovascular system, were can predict their effect and measurement by ultrasound and Doppler study. These risk factors included increased intima-media thickness, resistive index (RI) and pulsatility index (PI) of the right common carotid arteries. Method: We studied 20 patients with diabetes and hypertension, and 20 patients with diabetes only, were examine right carotid arteries for these two groups. In this sample we studied the Lumen diameter of the Rt. carotid arteries, Intima – media thickness (IMT), peak systolic velocity, end diastolic velocity, and Pulsatility index, Resistance index were measured. Results: Showed that the change differences in Intima – media thickness and Lumen diameter between patients with diabetes and hypertension than diabetes only were (-18.29%), (-11.26%) respectively with significant (p value <0.05). On the other hand the change difference in peak systolic velocity was (21.25%) for diabetes and hypertension, and diabetes only, with significant p value <0.05. The end diastolic velocity is higher value at DM group than diabetic and hypertensive group with significant p value. The change difference between Pulsatility and Resistance Index for both patients group were (-18.18%), (-16.12) respectively, with significant (p value <0.05). Conclusion: Spectral waveform indices of Rt. Internal carotid artery including Peak systolic velocity (PSV); End-diastolic velocity (EDV), Resistive index (RI) and Pulsatility index (PI) are profound predictive value of atherosclerosis, cardiovascular disease and ischemic changes in Diabetic and hypertensive Iraqi patients beside the intima –media thickness increment and lumen diameter change effect of common carotid artery