Objectives: Arterial stiffness manifested by high pulse wave velocity (PWV) consists a risk factor of atherosclerosis and cardio-vascular complications. Systemic lupus erythematosus (SLE) is a generalized autoimmune disease in which patients' prognosis depends contemporarily, in the corticosteroid era, mainly on the progression of premature atherosclerosis. The aim of the study was to assess arterial stiffness in patients with coronary atherosclerosis (CA), cardiac syndrome X (CSX) and SLE. Materials and methods: 44 CSX patients (28 females and 16 males; mean age 55,7; arterial hypertension in 32), 44 CA patients (19 females and 25 males; mean age 61,3; arterial hypertension in 41), 29 SLE patients (25 females and 4 males; mean age 37,4; arterial hypertension in 7), 29 control group (CG) patients. PWV was measured with use of SphygmoCor in all patients. Results: Patients with CSX had significantly lower PWV (9,63±1,69 m/s) as compared to CA patients (11,53±2,19 m/s) and significantly higher as compared to CG (8,07±1,03m/s) patients. The results of PWV in CSX and SLE patients (8,87±2,1 m/s) were similar. PWV increased with age and blood pressure in all groups. Diabetes mellitus and smoking caused PWV increase only in CA patients. Inflammatory markers didn't influence PWV among patients with CA, CSX and SLE. Conclusions: Patients with CA have the highest arterial stiffness and significantly higher peripheral and central blood pressure. In SLE patients arterial stiffness is higher as compared to control group and similar as compared to the older CSX group. Diabetes mellitus and smoking increase arterial stiffness among CA patients. The prognostic value of PWV decrease in SLE patients should be addressed in large prospective clinical trials. JRCD 2015; 2 (2): 43-51