Ilex paraguariensis aqueous extract (mate) is an antioxidant-rich beverage widely consumed in South American countries. Here we questioned whether mate could reduce the progression of atherosclerosis in 1% cholesterol-fed rabbits. New Zealand White male rabbits (n = 32) were divided into four groups: control (C, n = 5), control-mate (CM, n = 5), hypercholesterolemic (HC, n = 11) and hypercholesterolemic-mate (HCM, n = 11). The daily water and mate extract consumption was approximately 400 ml. After 2 months of treatment, mate intake did not change the lipid profile or hepatic cholesterol content of control or hypercholesterolemic rabbits (p < 0.05). However, the atherosclerotic lesion area was considerably smaller in the hypercholesterolemic-mate group (HCM, 35.4% vs. HC, 60.1%; p < 0.05). In addition, the aortic cholesterol content was around half that of the HC group (HCM, 36.8 vs. HC, 73.9 microg/mg of protein, p < 0.05). In spite of this, the thiobarbituric acid-reactive substances (TBARS) in the atherosclerotic aorta, liver and serum, and the activity of the antioxidant enzymes in liver and aorta did not differ among groups (p > 0.05). The results showed that Ilex paraguariensis extract can inhibit the progression of atherosclerosis in cholesterol-fed rabbits, although it did not decrease the serum cholesterol or aortic TBARS and antioxidant enzymes.