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Objective: Reservoir-excess pressure measured using tonometry methods predicts cardiovascular events, but the operator-dependency of tonometry is an impediment to widespread use. A cuff-based blood pressure device has been developed to derive reservoir-excess pressure from measured brachial pressure waveforms, but whether this method is independently associated with cardiovascular risk has never been investigated and this was the aim of this study. Methods: 1874 adult participants (age 43.7 ± 5.2 years, 11% male) from the Longitudinal Study of Australian Children’s Child Health CheckPoint study had reservoir pressure (RP) and excess pressure (XSP) derived from the brachial pressure waveform measured using cuff oscillometry (SphygmoCor XCEL, AtCor Medical, Sydney). Central hemodynamics (augmentation index and central blood pressure) were estimated from the central pressure waveform. Carotid intima-media thickness (cIMT, n = 1467) and carotid-to-femoral pulse wave velocity (cf-PWV, n = 1674) were measured as end-organ markers of cardiovascular risk. Results: XSP and RP were associated with cIMT after adjusting for age, sex, waist-to-hip ratio, heart rate (HR) and central hemodynamic indices (β = 0.070, p = 0.027 and β = 0.052, p = 0.047). RP was also significantly associated with cf-PWV after adjusting for the same variables as above (β = 0.128, p < 0.001). The additional reservoir-excess pressure variables in a model that originally included the Framingham risk score and HR strengthened the evidence for associations with cIMT and cf-PWV (p < 0.001 for all R2 changes). Conclusion: Cuff-based measures of reservoir-excess pressure are significantly associated with end-organ markers of cardiovascular risk independent of traditional risk factors. This cuff method may provide additional information to improve cardiovascular risk stratification.