Background and Objectives: Endothelial dysfunction and vascular inflammation may be associated with variant angina (VA). Loss of adequate endothelial cell function is most widely quantified by assessing flow-mediated dilation (FMD) or measuring plasma markers such as von Willebrand factor (VWF). The aim of the presents study is to investigate whether the level of VWF and FMD are related to VA. Subjects and Methods: The study included 56 patients (VA group: 52.7짹11.7 years, 26 males) with normal coronary angiogram (CAG) and positive spasm provocation test, and 30 patients (control group: 49.9짹11.0 years, 14 males) with normal CAG and negative spasm provocation test. Clinical characteristics, inflammatory markers including high sensitivity C-reactive protein (hs-CRP) and white blood cell (WBC) count and VWF, and FMD were compared between the two groups. FMD and inflammatory markers were measured in the morning before CAG with ergonovine provocation test. Results: The level of VWF was significantly higher in VA group than in control group (163.0짹43.2% vs. 119.0짹58.1%, p=0.001). FMD was significantly decreased in VA group compared with control group (9.6짹4.3% vs. 12.0짹3.1%, p=0.004). Nitrate-mediated dilation did not differ between the two groups. The levels of monocyte count and hs-CRP were higher in VA group than in control group (554.7짹261.0/��� vs. 440.7짹136.0/���, p=0.039; 0.3짹0.4mg/dL vs. 0.1짹0.1mg/dL, p=0.015). Multivariate logistic regression analysis revealed that increased level of VWF (odds ratio 5.91, 95% confidence interval 1.90 to 18.41, p<0.02) and decreased FMD (odds ratio 5.88, 95% confidence interval 1.93 to 17.88, p<0.02) were an independent predictor of VA. Conclusion: Endothelial dysfunction and inflammatory markers play an important role in VA patients. The increased level of VWF and decreased FMD for endothelial function may be used to screen the VA patients.