Background: Brachial-ankle pulse wave velocity (baPWV), a simple non-invasive means of measuring arterial stiffness, reflects degree of systemic atherosclerosis. We evaluated relationship between coronary artery stenosis detected by multislice computed tomography (MSCT) angiography and baPWV in patients with type 2 diabetes. Methods: The study group comprised 83 patients with type 2 diabetes over age 30 years. baPWV was measured with a non invasive pulse wave analyzer (VP 1000, Colin). The percent (%) stenosis of coronary artery and coronary calcium score were measured by MSCT angiography. Presence of stenosis was defined as more than 20% stenosis of the coronary artery lumen and significant stenosis was defined as more than 50% stenosis. Results: A receiver operating characteristic curve demonstrated that the best cut-off point of a baPWV for predicting subclinical coronary narrowing was 1,650 cm/s. baPWV was positively associated with the severity of coronary artery stenosis (r=0.214, p=0.040) and calcium score (p=0.605, p<0.001). The multivariate analysis revealed that a baPWV of 1,650 cm/s or higher was a significant and independent predictor of a coronary artery disease detected by MSCT angiography (OR 3.85, 95% CI 1.54-9.58, p=0.004) in addition to the age > 65 yrs, current smoking and calcium score > 100. Conclusions: The present study shows that baPWV is significantly associated with severity of coronary artery stenosis detected by MSCT coronary angiography and can be used as a potential marker for predicting coronary artery disease in patients with type 2 diabetes. Key words: Coronary artery disease, Diabetes mellitus