Arterial hypertension is the leading cause of mortality in the world. The risk stratification of hypertension patients is based on blood pressure values, traditional risk factors, subclinical organ damage and established cardiovascular disease. There is growing interest in assessment of subclinical organ damage, as early cardiovascular disease prevention is essential in these patients. Recently, aortic pulse wave velocity (PWV) and carotid artery intimamedia thickness (IMT) were added to international guidelines as markers of subclinical organ damage. Aortic PWV and carotid artery IMT predict overall mortality and cardiovascular events in hypertension patients. Antihypertensive therapy reduces aortic PWV and carotid artery IMT; thus it has, in addition to blood pressure lowering, positive effects on subclinical organ damage reduction. The aim of this review was to clarify the importance of aortic PWV and carotid artery IMT assessment in clinical practice.