Background: This study aimed to compare the usefulness of arterial stiffness parameters, cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV), for evaluating future cardiovascular disease (CVD) in subjects with diabetes.Methods: The study subjects were 277 patients with type 1 or type 2 diabetes. All subjects were evaluated for vascular stiffness using CAVI (n = 154) or baPWV (n = 123). Carotid intima-media thickness (IMT) and the Suita score were also measured because these are established risk factors for future CVD. Associations of both CAVI and baPWV with these established parameters were evaluated in all subjects, and then in 172 subjects with adjustment for covariates by using propensity score matching.Results: In all subjects, CAVI and baPWV correlated significantly with both IMT (r = 0.470, P < 0.001, and r = 0.256, P = 0.004, respectively) and the Suita score (r = 0.558, P < 0.001, and r = 0.360, P < 0.001, respectively). The correlation between CAVI and IMT was more significant than that between baPWV and IMT (Z = 2.03, P = 0.042). Similarly, the correlation between CAVI and the Suita score was more significant than that between baPWV and the Suita score (Z = 2.07, P = 0.039). After adjustment by matching, significant correlations between CAVI and IMT (r = 0.459, P < 0.001) and between CAVI and the Suita score (r = 0.526, P < 0.001) were preserved, though only the association between baPWV and the Suita score was significant (r = 0.270, P = 0.011) while that between baPWV and IMT showed no significance. Again, CAVI showed a significantly stronger association with the Suita score than baPWV (Z = 1.99, P = 0.046).Conclusions: CAVI is more closely associated than baPWV with variables predicting future CVD in patients with diabetes.