Arterial stiffness is increasingly recognized as an impor-tant prognostic index and potential therapeutic target in patients with hypertension. It is closely linked to, but by no means synonymous with, raised blood pressure, and its physiopathology is still not fully understood. Aortic stiffness and arterial pulse wave reflections are key determinants of elevated central systolic pressure and are associated with adverse cardiovascular outcomes, independent of blood pressure. Indeed, the 2003 European Society of Hypertension guidelines on the management of hypertension acknowledge the potential role of arterial stiffness measurement in clinical management1 and have prompted the publication of a consensus document on the measurement of central blood pressure and hemodynamics. 2 A detailed expert consensus document has also been published on the methodologic and clinical issues around arterial stiffness. 3 Broader implementation of these techniques into routine care seems inevitable. In this review, we have examined recent research in this field published in Hypertension, focusing on mechanistic work, methods for measuring stiffness, important clinical associations, and effects of treatment.