Background The relationship between pulse pressure and prognosis in patients with chronic coronary syndrome (CCS) is contradictory. In the present study, we aimed to examine the relationship between intra-aortic pulse pressure (IAPP) and major adverse cardiovascular events (MACE) in patients with CCS undergoing percutaneous coronary intervention (PCI). Methods A total of 139 CCS patients who underwent elective PCI with regular one-year follow-up, were stratified into two subgroups according to IAPP. The primary outcomes included the occurrence of MACE, defined as cardiovascular death, acute myocardial infarction with ST-segment elevation (STEMI), acute myocardial infarction without ST-segment elevation (NSTEMI), target vessel revascularization (TVR), and stroke. Results The mean age of the patients was 57.6 ± 10.4 years, 32% of whom were female. The mean IAPP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were 54.0 ± 17.6 mmHg, 129.7 ± 20 mmHg, and 75.8 ± 11.8 mmHg, respectively. SBP, IAPP, and left ventricular ejection fraction (LVEF) were significantly higher in the high IAPP group (p