Abstract: Objective To investigate the effect of brachial-ankle pulse wave velocity（baPWV） on new-onset acute myocardial infarction（AMI）. Methods A retrospective cohort study was performed for the subjects who underwent baPWV examination during the follow-up of Kailuan Study Cohort from 2010 to 2017. The observation subjects were divided into three groups based on the levels of baPWV: ＜14, 14-＜18 m/s and ≥18 m/s. The incidence density of AMI in three groups was calculated. Log-Rank test was used to compare the differences of cumulative AMI incidence among three groups. The influence of baPWV on new-onset AMI was analyzed by Cox proportional risk model and restricted cubic spline. Results A total of 41 405 subjects were included in the study. During 2.66（1.07-5.39） years’ follow-up, 150 new-onset AMI cases were observed. The incidence density of AMI in three groups was 3.69, 12.79, and 26.65 per ten thousand person-years, respectively. Log-Rank test result showed the cumulative AMI incidence increased gradually from the subjects with the lowest baPWV to those with the highest baPWV（χ~2=77.75, P＜0.05）. Compared with subjects with baPWV＜14 m/s, Cox model showed HRs（95% CI） of AMI in those with baPWV 14-＜18 m/s and baPWV≥18 m/s was 1.77（1.04-3.01） and 1.93（1.03-3.60） after adjusting for age, sex, and other potential confounding factors, respectively. Restricted cubic spline analysis showed that there was a dose-response relationship between the HR of AMI and baPWV level. Conclusion The increased baPWV is a risk factor for new-onset AMI.