OBJECTIVES: To determine the measure of vascular compliance most closely related to age. DESIGN: A review of 22 studies relating aortic compliance to age and a discussion of other factors related to vascular compliance. MEASUREMENTS: Aortic compliance, elastic modulus, postmortem aortic changes, pulse wave velocity in the aorta, common carotid, lower limb and upper limb. RESULTS: 1. Aortic compliance and carotid artery compliance is closely related to age; 2. Compliance in the peripheral arteries, in 16 reports, appears less closely related to age; 3. There is evidence that aortic compliance is related to hypertension, cardiac function, and left ventricular hypertrophy and can be increased by exercise, hormonal therapy, antioxidant and antihypertensive treatment; and 4. Vascular compliance is more closely related to chronological age than other measures such as skin inelasticity, greying of hair, baldness etc. CONCLUSIONS: Because of the close relationship between aortic and carotid compliance and chronological age, deviation from the age-predicted norm (biological age) may prove to be a good predictor of cardiovascular pathology.