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There is only scarce information regarding the physiological and health impact of lifelong wearing of the neck brass coils in Karen Kayan women. The purpose of this study was to determine the influence of wearing brass neck coils on cardiorespiratory and cerebrovascular functions in long-neck Karen women. A total of 28 Karen women (aged 23-66 years) were studied. Fourteen Karen women who had been wearing neck brass coils were compared with 14 Karen women with no neck coils. We also studied 14 age-matched city-living controls. Radiographic examination of 2 older Karen women wearing neck coils showed low levels of the clavicles. There were no group differences in resting heart rate and brachial-ankle pulse wave velocity. Both systolic and diastolic blood pressure was greater and functional capacity was lower in both Karen women than city-living controls (all p < 0.05). Karen women wearing neck coils demonstrated lower flow-mediated dilation, lung functions, including forced vital capacity and forced expiratory volume during the first second, and cerebral blood flow velocity than Karen women without neck coils (all p < 0.05). Karen women wearing neck coils demonstrate reduced endothelial and pulmonary functions as well as cerebral perfusion compared with age-matched Karen women without neck coils living in the same villages. Brass neck coils worn by Karen women may elevate risks of developing cardiopulmonary and cerebrovascular diseases. Novelty Cerebral blood flow velocity and macrovascular and microvascular functions were lower in Karen wearing neck coils. There appears to be substantial burden of brass neck coils exerted on physiological systems in Karen women.