BACKGROUND Brachial-ankle pulse wave velocity (baPWV) was a marker of arterial stiffness, and increased baPWV was associated with renal function progression in patients with chronic kidney disease (CKD). However, there was no study to evaluate the longitudinal change of baPWV in patients with CKD. The aims of this study were to assess whether there was a longitudinal change in baPWV and to find out the determinants of this change in patients with CKD. METHODS This study enrolled 52 patients with CKD stages 3 to 5 from outpatient Department of Internal Medicine. The values of baPWV were measured by an ankle-brachial index-form device at baseline and at 2-year follow-up. Changes of parameters (Δ) were used to evaluate the relationship between biological markers, blood pressures, medications and baPWV. RESULTS The values of baPWV decreased during the 2-year follow-up (2108.4 ± 893.9 and 1897.1 ± 472.4; P = 0.016). There were also significant reductions in systolic and diastolic blood pressures during the 2-year follow-up, and Δsystolic blood pressure and baseline baPWV were the major determinants of ΔbaPWV. CONCLUSIONS The present longitudinal study showed that the values of baPWV decreased during the 2-year follow-up, and the major determinants of ΔbaPWV were Δsystolic blood pressure and baseline baPWV in patients with CKD. Good control of systolic blood pressure may be associated with the regression of baPWV in patients with CKD.