Background/Aims: Arterial stiffness is closely associated with cardiovascular mortality in end-stage renal disease (ESRD) patients, We investigated whether kidney transplantation (KT) can improve arterial stiffness in patients with ESRD. Methods: We measured the change of arterial stiffness by brachial-ankle pulse wave velocity (baPWV) and ABI (Ankle-brachial blood pressure index) before and after KT. Fifty six patients were included and these patients were divided into improvement and non-improvement groups based on change of baPWV after KT .We also compared risk factors which affect arterial stiffness between two groups. Results: Overall arterial stiffness measured by baPWV after KT showed significant improvement (1456.09±232.99cm/s) compared to those of before KT (1550±2962 cm/s) (p<0.05 vs after KT). Mean ABI levels after KT were also significantly changed compared to those of before KT (1.17±0.14 m/s vs 1.11±0.09 m/s, p<0.05). 36 out of 56 patients (64.3%) showed improvement of baPWV after KT, but 20 patients did not. Between two groups, improvement group showed higher pre-transplant baPWV than no-improvement group (1608.41±248.47 vs. 1396.65±171.44), and multivariate analysis revealed that , gender was an independent risk factor of change of baPWV. Conclusions: Arterial stiffness in ESRD patients improves after transplantation, and, the better improvement was observed in patients with high baPWV before KT.