The purpose of this study was to determine the effects of acute cold exposure on the timing and amplitude of central aortic wave reflection and central pressure. We hypothesized that cold exposure would result in an early return of reflected pressure waves from the periphery and an increase in central aortic systolic pressure as a result of cold induced vasoconstriction. Twelve apparently healthy men (age 27.8 ± 2.0 years) were studied at random, in either temperate (24°C) or cold (4°C) conditions. Measurements of brachial artery blood pressure and the synthesis of a central aortic pressure waveform (by noninvasive radial artery applanation tonometry and use of a generalized transfer) were conducted at baseline and following 30 minutes in each condition. Central aortic augmentation index (AI), an index of wave reflection, was calculated from the aortic pressure waveform. Cold induced an increase (p<0.05) in AI from 3.4 ± 1.9 to 19.4 ± 1.8 %. Cold increased (p<0.05) both brachial and central systolic pressure, however the magnitude of change in central systolic pressure was greater (p<0.05) than brachial (13% vs. 2.5%). These results demonstrate that cold exposure and the resulting peripheral vasoconstriction increase wave reflection and central systolic pressure. Additionally, alterations in central pressure during cold exposure were not evident from measures of brachial blood pressure.