Objective To analyze the carotid stiffness before and after kidney transplant in the patients with end-stage renal disease (ESRD) supported by hemodialysis, and to explore the impact of maximum shear rate (SRmax) on carotid stiffness. Methods Thirty-one kidney transplant recipients (KTR), 31 patients with end-stage renal disease (ESRD) supported by hemodialysis, and 84 age- and gender-matched control subjects were included this study. The pulse wave velocity (PWV) which is regarded as the “gold standard” index of arterial stiffness and SRmax were measured in bilateral carotid arteries, and their relationships were analyzed. Results ① When comparisons were made between each groups, the bilateral carotid stiffness were all greater in ESRD group and KTR group than those in control group (P＜0.05). There was no marked difference in bilateral carotid stiffness between ESRD group and KTR group (P>0.05) .Compared with control group, Left SRmax was less than that in ESRD group and KTR group (P＜0.05). Right carotid SR had no significant difference in three groups (P>0.05). ② The intra-group comparison showed in ESRD group, the right carotid stiffness was greater than that on the left. In control group and KTR group, the carotid stiffness had no significant difference between left and right. In control group, the carotid SRmax had significant difference between left and right (P＜0.05)and the left was greater than that of right. There was no significant difference between left and right SRmax in ESRD group and KTR group. ③ The bilateral carotid stiffness was positively associated with age, systolic and diastolic blood pressure, and it was negatively associated with the SRmax ( all P＜0.05). Conclusion It showed a negative relation between carotid stiffness and SR, but the change of carotid stiffness was not very noticeable in KTR.