This study evaluated the validity and reproducibility of noninvasive brachial-ankle pulse wave velocity (baPWV) measurements and examined changes in baPWV in patients with coronary artery disease (CAD). The study involved 41 patients with CAD, vasospastic angina, or cardiomyopathy, and compared baPWV with aortic pulse wave velocity (PWV) measured using a catheter tip with a pressure manometer. In 32 subjects, baPWV was measured by two observers, while in 55 subjects, it was measured twice by a single observer on different days. The results showed a strong correlation between baPWV and aortic PWV (r = 0.87, p < 0.01). Interobserver and intraobserver reproducibility were high, with Pearson's correlation coefficients of 0.98 and 0.87, respectively, and coefficients of variation of 8.4% and 10.0%. baPWV was significantly higher in CAD patients compared to non-CAD patients with risk factors, and also higher in non-CAD patients with risk factors compared to healthy subjects without risk factors. These findings suggest that baPWV is a valid and reproducible measure of vascular damage. The study also demonstrated that baPWV is suitable for screening vascular damage in large populations. The method is simple, noninvasive, and feasible for widespread use. The results indicate that baPWV is an acceptable marker for vascular damage, comparable to carotid-femoral PWV. The study confirms the validity and reproducibility of noninvasive baPWV measurements, suggesting that it is a useful tool for assessing vascular damage in clinical practice.This study evaluated the validity and reproducibility of noninvasive brachial-ankle pulse wave velocity (baPWV) measurements and examined changes in baPWV in patients with coronary artery disease (CAD). The study involved 41 patients with CAD, vasospastic angina, or cardiomyopathy, and compared baPWV with aortic pulse wave velocity (PWV) measured using a catheter tip with a pressure manometer. In 32 subjects, baPWV was measured by two observers, while in 55 subjects, it was measured twice by a single observer on different days. The results showed a strong correlation between baPWV and aortic PWV (r = 0.87, p < 0.01). Interobserver and intraobserver reproducibility were high, with Pearson's correlation coefficients of 0.98 and 0.87, respectively, and coefficients of variation of 8.4% and 10.0%. baPWV was significantly higher in CAD patients compared to non-CAD patients with risk factors, and also higher in non-CAD patients with risk factors compared to healthy subjects without risk factors. These findings suggest that baPWV is a valid and reproducible measure of vascular damage. The study also demonstrated that baPWV is suitable for screening vascular damage in large populations. The method is simple, noninvasive, and feasible for widespread use. The results indicate that baPWV is an acceptable marker for vascular damage, comparable to carotid-femoral PWV. The study confirms the validity and reproducibility of noninvasive baPWV measurements, suggesting that it is a useful tool for assessing vascular damage in clinical practice.