To explore the clinical application value of ultrafast pulse wave velocity (ufPWV) technology in quantitative evaluation of carotid elastic recession in early hypertensive patients. Methods 66 patients in the normal control group and 90 patients in the hypertension group were detected. The hypertension group was divided into hypertension group 1 and hypertension group 2 according to the blood pressure level. Carotid intima-media thickness (cIMT) was measured by two dimension ultrasound, and pulse wave velocity of beginning systole (PWV-BS) and pulse wave velocity of end systole (PWV-ES) were measured by ufPWV technique. cIMT 0. 05cm was used as the threshold for the diagnosis of medial and middle membrane thickening, the normal group and the hypertension group 1 and 2 were further divided into two subgroups: Group A (cIMT≤0.05cm) and Group B (cIMT＞0.05cm). Pearson's correlation analysis was used to investigate the variation trend of cIMT, PWV-BS and PWV-ES in these three groups and their correlation with age, and to compare the differences of PWV-BS and PWV-ES in these three groups when cIMT was in the normal range (≤0.05cm). Results There were significant differences in age, body mass index, low density lipoprotein, high density lipoprotein, triglyceride and other parameters between the normal group and the hypertension group (all P＜0.05). The cIMT, PWV-BS and PWV-ES of hypertensive group 2 were higher than those of hypertensive group 1 and normal group. There were significant differences in Carotid elastic parameters cIMT and PWV-BS and PWV-ES in hypertension group 1, hypertension group 2 and normal group(all P＜0.05). Among them, hypertension group 2 ＞ hypertension group 1 ＞normal group. In the comparison of three parameters between hypertension group 2 and hypertension group 1, there were significant differences in PWV-ES(P＜0.05), but no significant differences in cIMT and PWV-BS (P＞0.05). The correlation between PWV-ES (r=0.693, P＜0.001; r=0.618, P＜0.001) and age was significantly better than correlation between PWV-BS(r=0.377, P=0.006; r=0.474, P＜0.001)and cIMT(r=0.417, P＜0.001; r=0.423, P=0.001)and age in normal group and hypertension group 1. The correlation between PWV-ES (r=0.872, P＜0.001) and age was significantly better than that between cIMT (r=0.486, P=0.003) and age, while there was no significant correlation between PWV-BS and age in hypertension group 2 (P=0.133). The regression analysis of carotid elastic parameters PWV-ES and age showed that the upward trend increased significantly orderly in the comparison between the normal group (β=0.089, P＜0.001) and the hypertension group (β=0.105, P＜0.001) and the hypertension group (β=0.118, P＜0.001). When cIMT≤0.05cm, there were 62 cases in normal group (normal group A), 11 cases in hypertensive group 1 (hypertensive group 1 group A) and 8 cases in hypertensive group 2 (hypertensive group 2 group A). PWV-BS and PWV-ES in hypertensive group 1 and group 2 were significantly different from those in normal group A(all P＜0.05). Conclusion The ufPWV technique can capture the changes in arterial elasticity before the thickening of cIMT, and it can be used as a simple and non-invasive method to quantitatively evaluate the changes in carotid artery elasticity in patients with early hypertension