Measurement of arterial pulse wave velocity is a good technique in which large artery elasticity is assessed from analysis of the peripheral arterial waveform. Pulse wave velocity is an index of arterial stiffness and a surrogate marker for atherosclerosis. It is inversely correlated with arterial elasticity and relative arterial compliance. The carotid-femoral (aortic) pulse wave velocity predicts cardiovascular morbidity and mortality in high risk patients with hypertension and hemo-dialysis. Aortic distensibility is reduced in the presence of coronary artery disease and left ventricular hypertrophy. A 1 m/s of increase in aortic pulse wave velocity increases risk of cardiovascular events approximately 39%. Serum lipids and lipoproteins such as oxidized low-density lipoprotein and paraoxonase 1 are important in atherosclerotic disease. Paraoxonase 1 is synthesized primarily in the liver and is secreted into the plasma, where it is closely associated with high density lipoproteins. Paraoxonase 1 prevents the formation of oxidized low density lipoprotein and it protects phospholipids in high density lipoprotein that has a potential cardio-protective function from oxidation. The association of paraoxonase 1 with pulse wave velocity is controversial. According to current data, there are a few studies in connection with activity of paraoxonase 1 and pulse wave velocity in the literature. Therefore, this connection was assessed in this review manuscript.