Aim To study relevance of essential hypertension (EH) patients with brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (cIMT) and homocysteine (Hcy), D-dimer. Methods The study was performed on 246 essential hypertension patients. According to baPWV they were divided into normal group (baPWV＜1700 cm/s) and abnormal group (≥1700 cm/s). According to cIMT they were divided into normal group (cIMT＜0.9 mm), thickening group (0.9 ≤cIMT＜1.2 mm), plaque group (cIMT≥1.2 mm). And Hcy, D-dimer and blood biochemistry were detected. Results Hcy and D-dimer levels in abnormal arterial stiffness group were significantly increased compared with those in normal arterial stiffness group (P＜0.05). Hcy and D-dimer levels in the normal cIMT group, the thickening group, the plaque group were gradually increased. Partial correlation analysis showed that after excluded age, weight, blood lipids and blood glucose, baPWV was positively correlated with Hcy and D-dimer (r＝0.18, r＝0.32, P＜0.05), cIMT was positively correlated with Hcy and D-dimer (r＝0.56, r＝0.27, P＜0.05), BaPWV was positively correlated with cIMT (r＝0.29, P＜0.05). Conclusion The increase of Hcy and D-dimer were correlated with cIMT and baPWV which predicted artery disease.