Psoriasis has been suggested to be an independent risk factor for cardiovascular disease, however available studies have shown inconsistent results. In this study, embedded within the population-based Rotterdam Study, we aimed to assess the association between psoriasis and cardiovascular outcomes. Adjusted means were calculated for subclinical atherosclerosis using general linear models. Using Cox regression, the hazards of cardiovascular events for psoriasis, as a time dependant variable, were calculated. A total of 262 psoriasis (24% systemic/UV treatment) and 8,009 reference subjects were followed for a mean of 11 years. Psoriasis patients were significantly younger, smoked more and had higher diastolic blood-pressure and BMI levels. The adjusted carotid intima-media-thickness was 1.02±0.18 mm for psoriasis and 1.02±0.16 mm for reference subjects. Similarly, crude and adjusted ankle-brachial index, pulse wave velocity and coronary artery calcium scores did not differ between the two groups. The risk of incident cardiovascular disease was not increased in psoriasis (adjusted HR0.73, 95%CI 0.50-1.06). The results were similar when coronary heart disease, stroke and heart failure were analyzed separately. Psoriasis patients with predominantly mild disease from the general population are as likely to develop atherosclerosis and cardiovascular events as subjects without psoriasis.Journal of Investigative Dermatology accepted article preview online, 14 March 2013; doi:10.1038/jid.2013.131.