In this paper, we propose a fully automatic method for extracting carotid artery contours from ultrasound images based on an active contour approach. Several contour extraction techniques have been proposed to measure carotid artery walls for early detection of atherosclerotic disease. However, the majority of these techniques require a certain degree of user interaction that demands time and effort. Our proposal automatically detects the position of the carotid artery by identifying blood flow information related to the carotid artery, and an active contour model is employed that uses initial contours placed in the detected position. Our method also applies a global energy minimization scheme to the active contour model. Experiments on clinical cases show that the proposed method automatically extracts the carotid artery contours at an accuracy close to that achieved by manual extraction.