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Introduction: Perceived neighborhood characteristics, including neighborhood satisfaction, are associated with lower obesity rates and more favorable cardiovascular risk factor profiles. However, prior studies have not evaluated how longitudinal changes in perceived neighborhood characteristics following revitalization efforts may associate with cardiometabolic health indicators.Methods: Changes in neighborhood perception scales (infrastructure, safety, aesthetics, and satisfaction) were determined from 2013-2016 and categorized into the following groups: improvement, no change, or worsening over the time-period. Multivariate linear regression was used to measure the association between perceived improvement in each of the neighborhood characteristics with cardiometabolic outcomes (BMI, SBP, HbA1c, HDL-c) assessed in 2016. Outcomes were compared for those who perceived neighborhood improvements to those who perceived no change/worsening of neighborhood characteristics. Models were adjusted for age, sex, income, education, marital status, physical function, neighborhood, years spent in neighborhood. Interaction terms for age and sex were tested in the adjusted models.Results: Among the 622 individuals who did not move during the time-period, 93% were African American, 80% were female, and the mean age was 58 years. Many participants reported some improvements in neighborhood environment; infrastructure (48% reporting improvements), safety (47%), aesthetics (46%) and satisfaction (28%). In covariate-adjusted models, those who perceived improvement in their neighborhood aesthetics over the follow-up period had a significantly higher BMI (kg/m2) than those who perceived no improvement/worsening (β=1.2, p=0.05). Similarly, perceived improvements in neighborhood safety were associated with higher BMI (β=1.5, p=0.01); however, they were also significantly associated with lower SBP (mmHg) (β=-3.8, p=0.01). A significant interaction was observed between sex and perceived improvement in safety when predicting BMI (interaction term p=0.04), such that the relationship between perceived improvements in safety and higher BMI was observed only among women (β=2.3, p=0.02). We did not observe any statistically significant interactions by age. We also did not find significant associations between changes in neighborhood characteristics and HDL-c or HbA1c.Conclusions: These findings suggest that perceived neighborhood characteristics may have differing associations with multiple cardiometabolic outcomes (BMI, SBP). This highlights the complexity of the associations between neighborhood characteristics and health as well as the importance of considering how changes in perceived neighborhood characteristics associate with multiple clinically relevant cardiometabolic risk factors, and how associations may be sex dependent.