Objective:To explore the correlation among morning blood pressure surge (MBPS) ,ambulatory arterial stiffness index (AASI) and carotid artery intima‐media thickness (IMT) .Methods :A total of 212 hypertension pa‐tients received 24h ambulatory blood pressure monitoring and carotid artery ultrasonography to measure carotid IMT .According to IMT thickened or not ,they were divided into normal IMT group (n=84) and thickened IMT group (n = 128) ,then MBPS and AASI were calculated .According to MBPS existed or not ,patients were divided into MBPS group (n = 120) and no MBPS group (n = 92) ,then the correlation among MBPS ,AASI and carotid IMT were observed .Results : Compared with normal IMT group ,there were significant rise in AASI [ (0.42 ± 0.13) vs .(0.68 ± 0.14)] and MBPS value [ (25.94 ± 4.57) mmHg vs .(36.57 ± 8.41) mmHg] in thickened IMT group , P < 0.05 both ;compared with no MBPS group ,there were significant rise in AASI [ (0.43 ± 0.13) vs .(0.71 ± 0.14)] and IMT [(1.01 ± 0.20) mm vs .(1.25 ± 0.17) mm] in MBPS group ,P < 0.05 both ;Linear correlation analysis indicated that MBPS and AASI were positively correlated with carotid IMT ( r = 1.22 ,0.51 , P < 0.05 both) .Conclusion : Morning blood pressure surge and ambulatory arterial stiffness index are independent risk factors for carotid artery intima‐media thickness ,and they possess predictive value .