Objective To study the association of insulin resistance ( IR ) with aortic compliance impairment in patients with essential hypertension (EH). Methods Thirty-five patients with EH and 35 healthy control subjects were enrolled. The two groups were matched by sex, age and weight Blood pressure was measured and high resolution color Doppler examination was performed. Pressure-strain elastic modulus ( EP) and stiff index were calculated to reflect the change of aortic compliance in all subjects. Fasting plasma glucose (FPG) was assayed with oxidase technique, serum fasting insulin ( Fins) was assayed with chemoluminescent technique, Calculate insulin resistance index (HOMA-IR) was calculated using FPG and FINS. Results In the EH group, Fins, HOMA-IR and EP of ascending aorta were ( 10. 15 ± 1.03) mU /L, 2. 21 ± 0. 68, (250. 79 ± 85. 52 ) kN/m2, respectively,and the stiff index( β) was 15. 60 ±7. 55. In the control group, Fins,HOMA-IR, EP and stiff index β were (6. 80 ± 3. 05) mU/L, 1. 48 ± 0. 16, (183. 90 ± 64. 65 ) kN/m2 and 10. 86 ± 4. 92, respectively. There were significant difference on these above mentioned indices between the two groups (P < 0. 05 ). In the EH group, HOMA-IR were positively correlated with the ascending aorta EP and stiff index β ( r = 0.558 and 0.601 respectively, P < 0. 05 ). Conclusions Aortic compliance impairment and IR are found in patients with EH. There is significant association of IR with aortic compliance impairment Hyperinsulinemia related to insulin resistance might be an important influential factor which promote large artery remodeling in patients with EH.