Abstract: Objective To investigate the relationship between plasma homocysteine（Hcy） and carotid-femoral pulse wave velocity（cfPWV） in the elderly. Methods This was a retrospective cross-sectional clinical study. Data including clinical characteristics, Hcy and cfPWV were collected from 696 inpatients admitted to Internal Medicine Department of The Sixth Hospital of Fuzhou from February 2015 to August 2017. Sex-specific tertiles of Hcy were determined. All patients were divided into two groups: the elderly（≥65 years old） and non-elderly（＜65 years old）. Difference in clinical characteristics and cfPWV was described among sex-specific tertiles of Hcy in both groups. Pearson correlation analysis,multiple linear stepwise regression and Logistic regression analysis were used to assess the relationship between plasma Hcy and cfPWV. Results In the elderly, cfPWV in the highest tertile of Hcy was higher than those in the median and lowest tertiles of Hcy （13.29±2.04） vs（11.80±1.87）,（11.91±1.76）m/s, P＜0.001. In the non-elderly, there was no difference in cfPWV among the tertiles of Hcy（P＞0.05）. In the elderly and non-elderly, the percentages of patients with cfPWV≥12 m/s were increased with the ascending tertiles of Hcy（in the elderly:38.6%,48.7%,74.6%,χ~2=19.720, P＜0.001;in the non-elderly:10.4%,17.5%,20.1%,χ~2=5.964,P=0.018）. The levels of plasma Hcy were associated with cfPWV in the elderly and non-elderly（in the elderly:r=0.223, P＜0.001; in the nonelderly; r=0.187, P＜0.001）. After adjustment of other cardiovascular risk factors,in the elderly, there was an independent association between Hcy levels and cfPWV, and patients with the highest tertile of Hcy had 4.771 fold risk of cfPWV≥12 m/s compared with those with the lowest tertile of Hcy OR（95% CI）=4.771（1.941-11.726）, P＜0.05. However, in the non-elderly, no relationship was observed between the levels of Hcy and cfPWV. Conclusion In the elderly, plasma Hcy was independently associated with cfPWV. Combined analysis of plasma Hcy and other cardiovascular risk factors may be helpful to more accurately assess the extent of arterial stiffness in elderly population.