Objective: There is evidence to suggest vascular involvement in the initiation and progression of osteoarthritis (OA). The relationship between large artery characteristics and pathogenesis of OA has not been investigated and was the aim of this study. Design: Large artery characteristics (i.e., aortic stiffness, brachial and central blood pressure (BP) variables) and bone marrow lesions (BMLs; measured by magnetic resonance imaging as a surrogate index of OA) were recorded in 208 participants (aged 63?7 years; mean?SD) with symptomatic knee OA. Relationships between large artery characteristics and BML were assessed by multiple regression adjusting for age, sex and body mass index. Results: There was a high prevalence of BML presence in the study population (70 ), but no significant difference between participants with and without BML for all large artery and BP variables (P>0.05 all). Furthermore, there were no significant relationships between BML size and aortic stiffness (r=-0.033, P=0.71), central pulse pressure (r=0.028, P=0.74), augmentation index (r=0.125, P=0.14), brachial pulse pressure (r=0.005, P=0.95) or brachial systolic BP (r=-0.066, P=0.44). When participants were stratified according to high or low aortic stiffness, there was no significant difference between groups regarding the proportion of those with a BML (64 vs 70 respectively; P=0.69). Conclusions: Variables indicative of large artery characteristics are not significantly correlated with BML size or presence in people with symptomatic knee OA. Thus, large artery characteristics may not have a causative influence in the development of OA, but this needs to be confirmed in prospective studies.