AIM Aortic stiffness is widely recognized as an important, independent determinant of cardiovascular risk. The cardio-ankle vascular index (CAVI) has been developed to estimate vascular wall stiffness which is theoretically less affected by varied blood pressure. The purpose of this paper was to evaluate the change of CAVI during one-year use of raloxifene (RLX). MATERIAL & METHODS Forty-eight women who visited the menopausal clinic in Tokyo Medical and Dental University were enrolled in this study. Twenty-two patients with osteopenia/osteoporosis (mean age 61.3 ± 1.1) out of 48 had RLX 60 mg/day (RLX group). The remaining 26 women (mean age 56.3 ± 1.0) had no medication and were recognized as younger, healthy control (control group). CAVI and ankle-brachial index were measured every 6 months, compared among 0, 6 and 12 months, in respective group. RESULTS CAVI showed a significant positive correlation to age by the single linear regression analysis. Control group indicated no change of age-adjusted CAVI through 12 months, but RLX group showed significant reduction of CAVI at 6 months and increased to the original level after 12 months. On the other hand, ankle-brachial index change showed significant increase in control group, but slight increase in RLX group, suggesting no increased risk of arterial stenosis. Furthermore, CAVI in the relatively younger group (50 to 59 years; n = 11) indicated stronger reduction at 6 months than older group, suggesting high sensitivity to RLX treatment in the younger group. CONCLUSION RLX treatment reduced CAVI value at 6 months which was superior in relatively younger group.