Abstract: Objective To evaluate arterial elasticity in children with essential hypertension by measuring carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV), and to explore the related influencing factors. Methods One hundred and sixty-six children diagnosed as essential hypertension in Children's Hospital Affiliated to Capital Institute of Pediatrics from April 2021 to April 2022 were selected as hypertension group, and according to the blood pressure levels, they were divided into hypertension grade 1 group (138 cases) and hypertension grade 2 group (28 cases). Thirty children with normal blood pressure who underwent physical examination in the hospital during the same period were selected as control group. The general clinical and biochemical indicators were recorded. The cfPWV was measured by SphygmoCor cardiovascular function detector, and the baPWV was measured by Omron arteriosclerosis detector. The influencing factors of cfPWV and baPWV in children with essential hypertension were identified by univariate and multivariate linear regression analysis. Results The cfPWV and baPWV of children in hypertension grade 2 group were significantly higher than those of children in hypertension grade 1 group and the control group 〖cfPWV: 5.8 (5.3, 6.6) vs 5.5 (5.0, 6.1) vs 5.1 (4.5, 5.4) m/s, H=16.609, P<0.001; baPWV: 1 073.8 (972.1, 1 174.0) vs 964.0 (886.0, 1 073.3) vs 907.8 (862.4, 980.6) cm/s, H=22.054, P<0.001〗. Multifactor linear regression analysis showed that body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were independent influencing factors of cfPWV (P<0.05), and age, SBP and DBP were independent influencing factors of baPWV (P<0.05). Conclusions The cfPWV and baPWV of children with essential hypertension were significantly increased, suggesting that their arterial elasticity decreased. Age, BMI, SBP and DBP may be independent risk factors for decreased arterial elasticity in children with essential hypertension.