Background: Endothelial dysfunction is considered one of mechanisms underlying variant angina (VA). However, its exact role remains to be clarified. The aim of the presents study was to investigate whether the level of von Willebrand factor (vWf), as a possible indicator of endothelial dysfunction, is increased in VA, and also whether it is related to flow-mediated dilation (FMD) in VA. Methods: The study included 46 patients (VA group: 47.2짹12.8 years, 20 males) with positive spasm provocation test and without significant coronary stenosis, and 14 patients (control group: 53.3짹11.7 years, 7 males) with negative spasm provocation test and without significant coronary stenosis. Clinical characteristics, inflammatory marker including highly sensitive C-reactive protein (hs-CRP) and monocyte count and vWf, and FMD were compared between the two groups. FMD and inflammatory markers were measured in the morning before ergonovine provocation coronary angiogram. Results: The level of vWf was significantly higher in VA group than in control group (166.5짹41.9 % vs. 118.0짹65.3 %, p=0.029). FMD was significantly decreased in VA group compared with control group (9.2짹4.3% vs. 12.4짹4.2%, p=0.021). Nitrate-mediated dilation did not differ between the two groups. The level of hs-CRP and monocyte count were significantly higher in VA group than in control group (0.3짹0.4 mg/dL vs. 0.1짹0.1 mg/dL, p=0.029; 554.7짹261.0/��� vs. 440.7짹136.0/���, p=0.039). Conclusion: Increased inflammatory markers and endothelial dysfunction are associated with variant angina.