OBJECTIVE： To observe clinical efficacy and safety of alprostadil combined with salvia ligustrazine in the treatment of aged patrents with unstable angina pectoris. METHODS： A total of 150 patients with unstable angina pectoris department of our hospital during Oct. 2011-Mar. 2015 were randomly divided into alprostadil group， salvia ligustrazine group and combination group according to random number table， with 50 cases in each group. Three groups received routine treatment. Alprostadil group additionally received Alprostadil injection 100 μg added into 0.9％ Sodium chloride injection 250 mL， ivgtt， qd， on the basis of routine treatment. Salvia ligustrazine group additionally received Salvia ligustrazine injection 10 mL added into 0.9％ Sodium chloride injection 250 mL， ivgtt， qd， on the basis of routine treatment. Combination group additionally received constant dose of Alprostadil injection and Salvia ligustrazine injection. Hemorheological indexes （high shear whole blood viscosity， low shear whole blood viscosity， plasma viscosity， hematocrit， fibrinogen）， cardiac function indexes （LVEF， SV， LVEFD， LVST）， serum CRP， NO， ET， SOD and clinical efficacies were observed in 2 groups before and after treatment； the occurrence of ADR was compared between 2 groups. RESULTS： Before treatment， there was no statistical significance in hemorheological indexes， cardiac function indexes or serum CRP， NO， ET， SOD level  between 2 groups （P＞0.05）. After treatment， plasma viscosity， the whole blood high and low shear viscosity， hematocrit， fibrinogen， serum CRP and ET levels of 3 groups were decreased significantly， while LVEF， SV， serum levels of NO and SOD were increased significantly， combination group was significantly better than alprostadil group and salvia ligustrazine group， with statistical significance （P＜0.05）. There was no statistical significance in above indexes between alprostadil group and salvia ligustrazine group （P＜0.05）. Total response rate of combination group was 90.00％， which was significantly higher than 74.00％ of alprostadil group and 72.00％ of salvia ligustrazine group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Alprostadil combined with salvia ligustrazine can effectively reduce the blood viscosity of patients with unstable angina pectoris， improve cardiac function and endothelial function， reduce myocardial ischemia injury and show significant therapeutic efficacy and safety without increasing the incidence of ADR.