Objective To investigate the association between blood pressure variability (BPV) and limb-shaking transient ischemic attack (LS-TIA).Methods A total of 19 patients with LS-TIA were enrolled as LS-TIA group, 32 patients with transient ischemic attack (TIA) were enrolled as TIA group, and 33 individuals who underwent physical examination were enrolled as normal control group. Ambulatory blood pressure monitoring was performed for all groups, and mean 24-hour systolic blood pressure (SBP), mean daytime SBP (d-SBP), mean nighttime SBP (n-SBP), mean 24-hour diastolic blood pressure (DBP), mean daytime DBP (d-DBP), and mean nighttime DBP (n-DBP) were measured. The 24-hour systolic blood pressure variability (SBPV), daytime SBPV (d-SBPV), nighttime SBPV (n-SBPV), 24-hour diastolic blood pressure variability (DBPV), daytime DBPV (d-DBPV), and nighttime DBPV (n-DBPV) were calculated.Results Compared with the normal control group, the LS-TIA group and the TIA group had significant increases in 24-hour SBP, d-SBP, n-SBP, 24-hour DBP, d-DBP, n-DBP, and pulse pressure index (all P<0.05). Compared with the TIA group, the LS-TIA group had a significant increase in pulse pressure index (P<0.05). Compared with the normal control group, the LS-TIA group had significant increases in 24-hour SBPV, d-SBPV, n-SBPV, 24-hour DBPV, d-DBPV, and n-DBPV, and the TIA group had significant increases in 24-hour DBPV, d-DBPV, and n-DBPV (P<0.05 or P<0.01). Compared with the TIA group, the LS-TIA group had significant increases in 24-hour SBPV, d-SBPV, 24-hour DBPV, and d-DBPV (all P<0.05).Conclusions Compared with patients with TIA, patients with LS-TIA have an increase in BPV, which may be one of the causes of LS-TIA. Compared with healthy controls, patients with LS-TIA have an increase in blood pressure, which may be compensatory increase in blood pressure after LS-TIA hypoperfusion. Compared with patients with TIA, patients with LS-TIA have an increase in pulse pressure index, indicating that LS-TIA patients have a higher degree of vascular sclerosis.