AIM: Although several risk factors contribute to the development of sarcopenia, whether preclinical atherosclerosis contributes to the risk of sarcopenia is not established. The present cross-sectional study aimed to investigate if there is an association between preclinical atherosclerosis and muscle strength among two ethnic populations. METHODS: Participants included individuals aged ≥40 years and enrolled in the third follow-up examination of the Andhra Pradesh Children and Parents Study, India, and in the baseline assessments of the Nagasaki Islands Study, Japan. Preclinical atherosclerosis was evaluated by carotid intima-media thickness, brachial-ankle pulse wave velocity, cardio-ankle vascular index. The association of carotid intima-media thickness and pulse wave velocity/cardio-ankle vascular index with handgrip strength (HGS) was analyzed separately in the sexes and for hypertensive status from the two cohorts using a multivariable linear regression model. RESULTS: Data on a total of 1501 participants in India and 3136 participants in Japan were analyzed. Carotid intima-media thickness was negatively associated with HGS in non-hypertensive Indian men (B coefficient = -5.38, P = 0.036). Arterial stiffness was also associated with HGS in non-hypertensive Indian men (B = -0.97, P = 0.001), but not in hypertensive Indian men. Same as Indian men, we found the significant associations between arterial stiffness and HGS in non-hypertensive women in both India and Japan (B = -0.44, P = 0.020, B = -0.63, P = 0.016, respectively), but not in hypertensive women. CONCLUSIONS: The negative association between preclinical atherosclerosis and HGS was dominantly found in non-hypertensive participants. Geriatr Gerontol Int 2018; 18: 1071-1078.