It has been shown that presence of carotid artery intraplaque hemorrhage (IPH) is associated with fibrous cap rupture (FCR), which is one of the major causes of ischemic cerebrovascular events. However, the role of different age of IPH in occurrence of IPH remains unclear. This study investigated the association between the age of IPH and FCR in carotid arteries using MR imaging. We found that fresh IPH volume was independently associated with FCR (odds ratio: 1.826; 95% CI: 1.130-2.949; P=0.014). Compared with recent IPH, fresh IPH was a stronger predictor for FCR (area under the curve: 0.79 vs. 0.64).