To investigate the association of serum lipids with non-invasively assessed systemic arterial compliance in a group of newly diagnosed coronary artery disease patients and their matched controls. Systemic arterial compliance is important in maintaining diastolic blood pressure and coronary perfusion, with decreased diastolic blood pressure in the presence of significant coronary artery disease suggested as contributing to increased morbidity. Decreased systemic arterial compliance is also associated with increased morbidity through its contribution to systolic hypertension. Despite the importance of arterial compliance, its association with biochemical factors is not certain. Twenty newly diagnosed coronary artery disease patients and disease-free controls were matched for age, sex, smoking status and total serum cholesterol level. Systemic arterial compliance was measured using applanation tonometry and Doppler velocimetry before instigation of treatment. There was no difference in group low-density lipoprotein or high-density lipoprotein cholesterol levels. Systemic arterial compliance was significantly less in the coronary artery disease group. For the groups combined, a significant negative correlation was demonstrated between systemic arterial compliance and low-density lipoprotein; however, on separate group analysis the correlation was confined to the coronary artery disease group. A significant difference was found in the association between systemic arterial compliance and diastolic blood pressure for the two groups. Increasing low-density lipoprotein cholesterol levels are associated with decreasing systemic arterial compliance; however, the identified intergroup differences suggest that, presumably because of differences in lipid-vessel wall interactions, disease-free subjects exhibit relatively less alteration in aortic mechanical properties than those who develop coronary artery disease.