BACKGROUND: To investigate the clinical differences between pulse wave velocity and augmentation index in diabetic retinopathy. METHODS: The subjects were 201 patients with type 2 diabetes. These subjects were measured for both augmentation index (AI) and brachial-ankle pulse wave velocity (baPWV) by a pulse wave analyzer. The relationships between AI, baPWV, and diabetic retinopathy were examined. RESULTS: BaPWV was significantly higher in patients with diabetic retinopathy than in individuals without the disease. (20.13 +/- 3.66 vs.17.14 +/- 3.60 m/s p < 0.001) AI was higher in patients with diabetic retinopathy, but not significantly. (19.5 +/- 15.2 vs. 14.8 +/- 20.5% p = 0.14) The association between baPWV and diabetic retinopathy remained statistically significant after adjustment. (Odds ratio: 1.21 Per m/s, 95% confidence interval: 1.07-1.37) On the other hand, the association between AI and diabetic retinopathy was not statistically significant. (Odds ratio: 1.01 Per %, 95% confidence interval: 0.98-1.03) CONCLUSION: BaPWV is associated with diabetic retinopathy, but AI is not. The clinical significance appears to be different between PWV and AI in patients with diabetes.