OBJECTIVE： To observe the clinical efficacy and safety of atorvastatin combined with levamlodipine besylate in the treatment of elderly patients with hypertension combined with carotid plaque. METHODS： 160 elderly patients with hypertension combined with carotid plaque were randomly divided into control group （80 cases） and observation group （80 cases）. Control group orally received Atorvastatin tablet 3 mg， qd+compound reserpine tablets 2 tablets，tid； observation group was received Atorvastatin tablet （the same dosage and usage with control group）+Levamlodipine besylate tablet 2.5 mg， qd. They were treated for 8 months. Antihypertensive efficacy， blood pressure， and carotid intima-media thickness （IMT） before and after treatment， and the incidence of adverse reactions in 2 groups were observed and recorded. RESULTS： The antihypertensive effective rate in observation group was significantly higher than control group， with statistical significance （P＜0.05）. Before treatment， there was no significant difference in blood pressure and IMT levels in 2 groups（P＞0.05）. After treatment， blood pressure and IMT levels in 2 groups were significantly lower than before， and observation group was lower than control group， with statistical significance （P＜0.05）. And there was no significant difference in the incidence of adverse reactions in 2 groups （P＞0.05）. CONCLUSIONS： Atorvastatin combined with levamlodipine besylate shows good efficacy in the treatment of elderly patients with hypertension combined with carotid plaque， which can not only effectively control patients’ blood pressure， but also improve atherosclerosis， reversing plaques and does not increase the incidence of adverse veactions.