Aortic pulse wave velocity (PWV) is a noninvasive vascular parameter that is related to cardiovascular risk. We studied the relationship between aortic PWV and aortic atherosclerosis assessed with transesophageal echocardiography (TEE). The patients referred for TEE before electrical cardioversion of atrial fibrillation were included in the study. Maximal intima-media thickness (IMT) including maximal atherosclerotic plaque thickness of the descending thoracic aorta was measured on TEE images. PWV was measured in those patients who had the sinus rhythm restored. Univariable linear regression was used to test associations between the parameters studied. Variables identified by linear regression, as significantly related to PWV, were further analyzed by multivariable linear regression models. We studied 99 patients (57 men, 42 women, mean age 70.4±11.5 years). With univariable regression, we found that PWV was significantly related to IMT (P<0.0001), age (P<0.0001) and pulse pressure (PP, P=0.005). There was no significant relationship between PWV and systolic, diastolic and mean blood pressures, as well as heart rate. The multivariable regression analysis, with all the variables significant in the univariable analysis in the model, showed that only IMT remained significantly related to PWV (P<0.0001, β=0.31), whereas age (P=0.18) and PP (P=0.16) were not. In conclusion, PWV is related to aortic atherosclerosis assessed with TEE independent of age and blood pressure.