OBJECTIVES: The aim of this study was to investigate the relationship between job stress and the pulse wave velocity as an indicator of vessel stiffness among male firefighters in a metropolitan city. METHODS: In November and December 2008, a total of 404 participants were analyzed. The questionnaire survey included the participants' general characteristics, job-related factors, health-related behaviors, and job stress. Job stress was measured using the Korean Occupational Stress Scale (KOSS). We merged the job stress data with clinical laboratory data and brachial-ankle Pulse Wave Velocity (baPWV) by conducting medical surveillance. We measured the relationship of job stress to baPWV by using a logistic regression analysis. RESULTS: After adjusting for cardiovascular risk factors, the baPWV was significantly higher in the groups possessing high levels of job insecurity (OR=2.17, 95% CI=1.06~4.42). CONCLUSIONS: Our findings suggest that the level of job stress, especially in regards to job insecurity, was directly related to the baPWV. Therefore, further preventive efforts and studies in regards to firefighters are needed in order to reduce job stress and thereby help to prevent cardiovascular disease.