Tortuous or twisted arteries, often seen in carotid and many other arteries, can lead to transient ischemic attacks to distal organs including stroke [1]. The mechanisms for the development of tortuous arteries remain unclear. Our recent studies [1, 2] suggested that artery bent buckling could be a possible mechanism for vessel tortuosity. However, these studies were performed under static pressure but arteries in vivo are usually under pulsatile flow where both the mean pressure and pulse pressure may change at physiological or pathological conditions. The aim of this study was to investigate the biomechanical buckling of arteries under pulsatile flow to determine the effect of pulsatile flow on the critical buckling pressure.