Background: Arterial stiffness, assessed by aortic pulse wave velocity (PWV), has been reported to predict cardiovascular morbidity and mortality. We therefore assessed the association between arterial stiffness, as determined by PWV, and occult coronary artery disease (CAD), as detected by multiple detector computed tomography (MDCT), in asymptomatic individuals. Method: We retrospectively enrolled 615 consecutive South Korean individuals who had undergone both brachial-ankle PWV (ba-PWV) and coronary CT angiography with 64-slice MDCT during general routine health evaluation at the Asan Medical Center in 2008. Results: We found that baPWV was positively correlated with age; body mass index; blood pressure; total cholesterol, homocysteine, and fasting blood glucose concentrations; and coronary artery calcium score. When we divided subjects into two groups according to the results of MDCT, we found that baPWV was significantly higher in subjects with (diameter of stenosis >50%) than without CAD (1,573.2짹275.6 cm/sec vs. 1,409.6짹235.6 cm/sec, p<0.01). The optimal baPWV cutoff value for detection of significant coronary arterial stenosis was 1,426.0 cm/sec, which had a sensitivity of 77% and a specificity of 63% (area under the curve = 0.71). After adjusting for age, smoking status, hypertension, diabetes, and dyslipidemia, the odds ratio for significant occult CAD was 3.30 (95% confidence interval, CI = 1.47-7.41, p<0.01) for a baPWV of at least 1,426.0 cm/sec. Conclusion: We found that baPWV was associated with risk factors for cardiovascular disease, including CACS, in asymptomatic individuals, and the optimal baPWV cutoff value for occult CAD detected by MDCT was 1,426 cm/sec. These findings suggest that baPWV may be a useful screening tool for predicting occult CAD.