Aim To investigate the prognostic significance of brachial-ankle pulse wave velocity on the incidence of hypertension in prehypertensive population. Methods Data of the present retrospective survey were collected from the Health Management Center of the 3rd Xiangya Hospital from 2004.12-2012.12. The baseline characteristics and outcomes of 205 prehypertensive population from the data were analyzed. Results During a median follow-up of 5.89 years, 54 people (26.34%) developed into hypertension; According to the tertiles of baseline brachial-ankle pulse wave velocity values the cases were divided into three groups, the cumulative incidence of hypertension increased from the first tertile to the third tertile, and the differences between three groups were statistically significant(P<0.001); Cox regression analysis showed that brachial-ankle pulse wave velocity was an independent risk factor for hypertension in prehypertensive population after adjusting of baseline age, gender, drinking, education, marriage, body mass index, glomerular filtration rate, fasting plasma glucose, total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein. The risk of development of established hypertension in those individuals with the third, second tertile of brachial-ankle pulse wave velocity at baseline were both higher than those with the lowest tertile of baseline brachial-ankle pulse wave velocity (HR=6.647,P<0.001; HR=3.008, P=0.040). In addition, baseline brachial-ankle pulse wave velocity values increased per 100 cm/s, the risk of development of established hypertension increased 22.3%(P=0.002). Conclusions The brachial-ankle pulse wave velocity is an independent risk factor of hypertension and might be used to predict the risk of development of established hypertension in prehypertensive population.