Backgroud and Objectives The aim of this study was to investigate impacts of arterial dysfunction on hemodynamic changes during treadmill exercise test. Methods A total of 113 patients (52.5짹10.3 years, 60 males) who underwent treadmill exercise test (TMT) using modified Bruce protocol were divided into two groups according to the pre-exercise heart-femoral pulse wave velocity (HFPWV); high HFPWV group (group I: 60 patients, 50.2짹10.9 years) vs low HFPWV group (group II: 53 patients, 56.1짹8.9 years). Hemodynamic responses at each stages and maximal blood pressure (BP) and rate pressure products (RPP) were compared between the groups during TMT. BP and RPP recovery within 2 minutes were also compared between the groups during the recovery stage of TMT. Results Group I showed significantly elevated BP response at 3 minutes of TMT than in group II; systolic BP (132.2짹10.9 vs 117.4짹15.2 mmHg, p=0.001), diastolic BP (77.5짹14.2 vs 69.1짹9.7 mmHg, p=0.002), RPP (121.1짹35.6 vs 103.1짹19.6, p=0.006). Maximal systolic, diastolic BP, and RPP were also significantly higher in group I than group II; systolic BP (172.7짹26.4 vs 149.0짹25.1 mmHg, p<0.001), diastolic BP (78.6짹15.7 vs 72.3짹12.0 mmHg, p=0.04), RPP (216.0짹69.8 vs 189.4짹61.0, p=0.04). BP and RPP recovery within 2 minutes were also significantly delayed in group I than in group II; systolic BP (158.2짹15.4 vs 136.3짹23.2 mmHg, p<0.001), diastolic BP (75.8짹15.4 vs 67.9짹11.9 mmHg, p=0.013), RPP (173.1짹52.9 vs 133.3짹55.5, p=0.001). Conclusion The results of this study suggested that arterial dysfunction is a significant predictor of abnormal BP response during TMT and delayed recovery of BP following exercise.