Abstract: Objective To investigate the relationship between advanced pregnancy and post-partum arteriosclerosis in women. Methods A total of 2 194 women who delivered between January 2000 and December 2020, had complete delivery records, and underwent postpartum brachial-ankle pulse wave velocity (baPWV) testing were included. Participants were divided into four groups based on age at delivery: <25 years (254 individuals), 25 to <30 years (1 303 individuals), 30 to <35 years (457 individuals), and ≥35 years (advanced maternal age group, 180 individuals). Multivariate poisson regression was used to analyze the impact of advanced maternal age on postpartum arteriosclerosis (baPWV≥14 m/s). Restricted cubic spline models were employed to explore whether a dose-response relationship existed between maternal age and the risk of arteriosclerosis postpartum. Stratified analysis was performed according to the interval of baPWV examination after delivery (whether ≥10 years), hypertension (with or without), and body mass index (whether ≥24 kg/m²). Results Compared with 25 to <30 years old group, the detection rate of arteriosclerosis in ≥35 years old group was higher (22.78% vs 8.44%;χ²=35.540, P<0.001). Multivariate Possion regression analysis showed that after adjusting for confounding factors such as age of physical examination, the risk of post-delivery arteriosclerosis in women aged ≥35 years increased by 55.0% compared with those aged 25 to <30 years (RR: 1.550; 95% CI 1.146-2.097). Restricted cubic spline plots showed that age of delivery was linearly associated with postpartum arteriosclerosis (P_overall=0.006; P_nonlinear=0.335). Stratified analysis showed that among those with interval of baPWV examination after delivery≥10 years, those without hypertension, and those with a body mass index ≥24 kg/m², women with delivery age≥35 years had an increased risk of developing atherosclerosis after delivery, compared with those with delivery age of 25 to < 30 years, RRs were 2.986 (95% CI 1.337- 6.668), 2.007 (95% CI 1.431-2.816) and 2.191 (95% CI 1.405-3.418), respectively. Conclusion Advanced pregnancy is a risk factor for postpartum arteriosclerosis in women, especially in those without hypertension, with interval of baPWV examination ≥10 years after delivery, and with a body mass index ≥24 kg/m². There is a dose-response relationship between age of delivery and the risk of developing atherosclerosis after delivery.