Abstract: Objective To investigate the efficiency of inter-arm systolic blood pressure difference（IASBPD） combined with brachial-ankle index（BAI） for screening subclavian stenosis. Methods We retrospectively enrolled all hospitalized patients who underwent supra-arch artery angiography and had done simultaneous four-limb blood pressure measurements within 5 days before angiography from October 2017 to October 2018 at Fuwai hospital. The gold standard of subclavian stenosis was defined as 50% or more diameter stenosis identified on angiography by blind method. The receiver operating characteristic（ROC） curve was used to calculate the optimal cut-off values of IASBPD and BAI. The efficiency of IASBPD combined with BAI for screening stenosis was further investigated. Results Three hundred and seventeen patients（634 subclavian arteries） were consecutively enrolled. In them, 246（77.6%） were male, with a mean age of（64.2±8.5） years. One hundred and thirty-three patients had stenosis ≥50%, and 33（24.8%） were bilateral. The optimal cut-off points of IASBPD and BAI for diagnosing stenosis≥50% were 9 mm Hg and 0.8, with the area under the ROC curve of 0.83（95%CI 0.79-0.88, P＜0.001） and 0.65（95%CI 0.60-0.71, P＜0.001）, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of IASBPD were 57.1%, 94.0%, 87.4% and 75.2%, respectively; that of BAI were 48.1%,86.4%, 71.9% and 69.7%, respectively. IASBPD combined with BAI significantly improved the sensitivity to 68.4%, while the specificity decreased to 82.6% compared with IASBPD or BAI alone. Conclusion IASBPD combined with BAI achieved greater sensitivity for screening subclavian stenosis.