This study investigated the effects of regular exercise participation on common carotid artery stiffness in patients recently diagnosed with transient ischaemic attack (TIA). A total of 21 male and 4 female participants (mean±s.d.; 66±12 years, 1.72±0.07 m, 85.5±12.4 kg), recruited within 2 weeks of TIA diagnosis, completed a risk stratification assessment (including fasting blood glucose, cholesterol), a health history questionnaire and underwent measures of arterial stiffness (compliance and distensibility). Participants were then randomized to either an exercise (EX; 8-week intervention) or a usual-care control (CON) condition. Identical measures were obtained post intervention. Within-subject, repeated measures analysis of variance, with Condition as the between-subject factor (EX and CON), was used to assess measures of arterial stiffness at the baseline and postintervention assessment. Results revealed a significant interaction whereby an increase in compliance (0.71±0.24 vs. 0.83±0.28 mm2 kPa(-1), P=0.048, partial η2=0.159) and distensibility (15.98±5.95 vs. 19.49±6.60 10(-3) kPa(-1), P=0.023, partial η2=0.204) was observed for EX but not for CON. The present study has demonstrated that engagement in exercise soon after TIA diagnosis leads to improved large artery health. These improvements in vascular health may reduce the risk of an ensuing or recurring cardio- or cerebrovascular event.