OBJECTIVE： To discuss efficacy and safety of Enalapril maleate folic acid tablets in the treatment of transient ischemic attack （TIA） complicating with H type hypertension. METHODS： 140 patients with TIA complicating with H type hypertension selected from our hospital and divided into observation group and control group according to admission order with 70 cases in each group. Control group was given Enalapril maleate tablets orally in the morning， with initial dose of 5-10 mg each day， 1-2 times a day， increasing gradually according to blood pressure， maximal dose no more than 40 mg/d. Observation group was given Enalapril maleate folic acid tablets orally in the morning， with initial dose of 5 mg/0.4 mg each day， increasing gradually according to blood pressure. Both groups received treatment for 12 months. Mean arterial pressure （MAP） and Hcy level of 2 groups were observed before and after treatment， the incidence of cerebrovascular accident and the occurrence of ADR were compared between 2 groups. RESULTS： Before treatment， there was no statistical significance in MAP and Hcy level between 2 groups （P＞0.05）. After treatment， MAP of 2 groups were decreased significantly， with statistical significance （P＜0.05）， but there was no statistical significance between 2 groups （P＞0.05）. Hcy level of observation group was lower than before treatment and control group， with statistical significance （P＜0.05）.  The incidence of cerebrovascular accident in observation group was significantly lower than in control group （8.57％ vs. 31.43％）， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Compared with Enalapril maleate tablets， Enalapril maleate folic acid tablets can significantly improve Hcy level of patients with TIA complicating with H type hypertension， and decrease the incidence of cerebrovascular accident with good safety.