Prehypertension and serum uric acid are emerging as independent risk factors for arterial stiffness and may also predict cardiovascular diseases. Previous studies have demonstrated the association between serum uric acid and arterial stiffness in hypertensive adults, but there are limited studies in prehypertensive adults. We compared the serum uric acid (SUA) and cardio-ankle vascular index (CAVI) between normotensive and prehypertensive participants. The association between SUA, prehypertension and CAVI were investigated. One hundred and eighteen participants were recruited and divided into two groups according to their blood pressure (normotensive, 53 and prehypertensive, 65). Blood pressure, resting heart rate, pulsatile stress, height, waist circumference and body composition were measured. After an overnight fast, blood samples were collected to measure lipid profile and SUA levels. Arterial stiffness was assessed according to the CAVI. The results showed that the SUA and CAVI of the prehypertensive group were significantly higher than those of the normotensive group. Multiple regression analysis demonstrated that CAVI was significantly correlated with age, systolic blood pressure and SUA. Furthermore, prehypertension and high SUA were significantly associated with increased risk of abnormal CAVI (relative risk, 2.696; 95% CI, 1.552-4.683; p < .001). The study demonstrated that prehypertension and high SUA significantly increased the risk of arterial stiffness as assessed by CAVI.