Aim To study the diagnostic value of brachial-ankle pulse wave velocity （baPWV） and ankle-brachial index （ABI） for early atherosclerosis （As） in patients with hypertension.Methods 2400 cases of patients with hypertension were collected from January 2010 to December 2014 in our hospital. These patients were divided into two groups: non-As hypertension group （1200 cases） and As hypertension group （1200 cases）. 1248 cases of healthy examination persons in the same period were regarded as the control group. baPWV, ABI and intima-media thickness （IMT） were detected and compared in the three groups.Results Compared with the control group, the levels of baPWV, SBP, DBP, TG and LDLC were significantly increased in the non-As hypertension group and the As hypertension group （P<0.05） Compared with the non-As hypertension group, the levels of baPWV, TG and LDLC were significantly increased in the As hypertension group （P<0.05）. Compared with the control group, the levels of ABI and HDLC were obviously decreased and the IMT thickening rate was significantly increased in the As hypertension group （P<0.05）, but the changes of ABI and IMT thickening rate were not obvious in the non-As hypertension group （P>0.05）. There was no obvious correlation between baPWV and ABI in the control group and the non-As hypertension group, but there was obviously negative correlation between baPWV and ABI in the As hypertension group （r＝-0.718，P<0.05）.Conclusions The baPWV and ABI can more accurately reflect vascular structure and function changes, and be obviously correlated with the As degree. They are helpful to the early diagnosis of As lesion for patients with hypertension.