Abstract: Objective：To investigate the association between Gensini score and ankle arm index and brachial-ankle pulse wave velocity in patients with coronary artery disease. Methods：Seventy six patients with coronary artery disease and thirty control subjects were recruited for this study. Brachial-ankle pulse wave velocity and ankle arm index were examined in all subjects. And the patients with coronary artery disease underwent coronary arteriography. Gensini score was used to evaluate the pathological change degree of coronary artery in the patients with coronary artery disease. Results：Ankle arm index was significantly reduced in coronary artery disease group compared with that in control group(0.80±0.12)vs (1.11±0.14), P<0.05. However, brachial-ankle pulse wave velocity was significantly increased in CAD group compared with that in control group (1 584±527)cm/s vs (1 324±509)cm/s, P<0.05. There was a negative association between decreased ankle arm index and increased pathological change degree of coronary artery (r=-0.686,P<0.01).There was a positive association between increased brachial-ankle pulse wave velocity and increased pathological change degree of coronaryartery (r =0.634，P<0.01).There was association between brachial-ankle pulse wave velocity(r=0.665,P<0.001) or ankle arm index(r=-0.703,P<0.001) and pathological change degree of coronary artery still after control gender, age, hypertension, smoking, body weight index and uric acid variables. Conclusion：There was a negative association between decreased ankle arm index and increased pathological change degree of coronary artery, although a positive association between increased brachial-ankle pulse wave velocity and increased coronary artery Gensini scores. The present study suggested that the measurement of ankle arm index or brachial-ankle pulse wave velocity might be used as a novel index for the determination of the pathological change degree of coronary artery.