Assessment of Carotid Intima-Media Thickness (CIMT) by B-mode ultrasound is a technically mature and reproducible technology. Given the high morbidity, mortality and the large societal burden associated with CV diseases, as a safe yet inexpensive tool, CIMT is increasingly utilized for cardiovascular (CV) risk stratification. However, CIMT requires a precise measure of the thickness of the intima and media layers of the carotid artery that can be tedious, time consuming, and demand specialized expertise and experience. To this end, we have developed a highly user-friendly system for semiautomatic CIMT image interpretation. Our contribution is the application of active contour models (snake models) with hard constraints, leading to an accurate, adaptive and user-friendly border detection algorithm. A comparison study with the CIMT measurement software in Siemens Syngo® Arterial Health Package shows that our system gives a small bias in mean (0.049 ±0.051mm) and maximum (0.010 ± 0.083 mm) CIMT measures and offers a higher reproducibility (average correlation coefficients were 0.948 and 0.844 in mean and maximum CIMT respectively (P <0.001)). This superior performance is attributed to our novel interface design for hard constraints in the snake models.