Purpose: The retina provides a non-invasive window to monitor microvascular circulation. Carotid-femoral Pulse Wave Velocity (cfPWV) is an indicator of large artery stiffness and is associated with systemic cardiovascular diseases. This study investigates whether Retinal artery PWV (rPWV) reflects cfPWV changes in an elderly cohort. Methods: A total of 37 elderly participants (28 female, age 79 ± 5 years) were studied. Participants with a history of diabetes, glaucoma, and any neurological or eye-related disorders were excluded. Twenty four subjects were taking antihypertensive medication. A 60-s recording of retinal arterial diameter changes were captured (25 Hz frame rate, Dynamic Vessel Analyzer). Systolic blood pressure, Diastolic Blood Pressure (DBP), cfPWV and Intraocular Pressure (IOP) were measured. A custom-written algorithm was used to extract pulse amplitudes from retinal arterial diameters within one- and three-disc diameters from the optic disc. rPWV was designated as the ratio of the distance between two sites along the artery to the time delay between pulses. Predictors of rPWV were assessed by linear regression and parameter selection techniques. Results: There was a positive correlation between rPWV and cfPWV (Pearson’s correlation coefficient 0.82, p < 0.001). In parameter selection models, cfPWV, transmural pressure (DBP–IOP), male sex, and IOP were isolated as predictors of rPWV. Conclusion: This study found a positive correlation between rPWV and cfPWV in an elderly cohort. This indicates that microvessel remodelling that parallels large vessel remodelling is able to be detected using rPWV measurement. Further longitudinal studies are required to elucidate the predictive value of screening rPWV in systemic cardiovascular abnormalities.