The handedness relationship between adjacent layers in nested double-wall carbon nanotubes (DWNTs) has been investigated for the first time. Our high-resolution electron microscopy analysis on a series of specimen tilts can successfully tell the handedness of each constituent nanotube in a DWNT, and therefore the chiral indices (n, m) including their optical isomers [(n, m) or (m, n)] of inner and outer nanotubes can be uniquely determined. It is shown that right-handed and left-handed nanotubes are equally distributed for both the inner and outer nanotubes in the examined specimens and a preferable handedness relationship between the adjacent layers in DWNT may exist.