Backgroud and Objectives Arterial stiffness is known to as a powerful predictor of survival in hemodialysis (HD) patients, but the changes of arterial function following HD were poorly evaluated. The aim of this study was to evaluate the impacts of acute preload reduction by HD on arterial function in patients with chronic renal failure (CRF). Methods A total of 61 patients (48.4짹14.4 years, 34 males) with CRF who underwent HD were enrolled. Pulse wave velocity (PWV) (VP 2000, Colins, Japan), augmentation index (AI) and pulse pressure (PP) (Gaon 21A system, Hanbyul, Korea) were measured as the parameters of arterial function before and after HD. Results The changes of arterial function following HD were summarized in table. Heart-carotid PWV (HCPWV) and heart-femoral PWV (HFPWV) were significantly reduced following HD. However, brachial-ankle PWV (BAPWV) and femoral-ankle PWV (FAPWV) were significantly increased following HD. Central aortic and peripheral arterial AI and PP were significantly reduced following HD. Conclusion PWV showed dual opposite changes according to the site of measurement, and AI and PP were reduced following HD significantly.