OBJECTIVE： To observe the clinical efficacy and safety of amlodipine besylate combined with lisinopril and hydrochlorothiazide， atorvastatin in the treatment of severe primary hypertension complicating with carotid atherosclerosis. METHODS： 90 patients with severe primary hypertension complicating with carotid atherosclerosis were divided into control group （45 cases） and observation group （45 cases） according to random lottery form. Both groups were given Atorvastatin calcium tablet 20 mg/time orally， qd； control group was additionally given Amlodipine besylate tablet 5 mg/time orally， qd； observation group was additionally given Lisinopril and hydrochlorothiazide tablet 10 mg/time orally， qd， on the basis of control group. Both groups were treated for 8 weeks. Clinical efficacies of 2 groups were compared as well as blood pressure level， IMT， PV of carotid atherosclerosis， hs-CRP， TNF-α before and after treatment. The occurrence of ADR was recorded. RESULTS： Total response rate of observation group was significantly higher than that of control group， with statistical significance （P＜0.05）. Before treatment， there were no significant differences in SBP，DBP，IMT，PV， hs-CRP and TNF-α level（P＞0.05）. After treatment， the levels of SBP， DBP， IMT， PV， hs-CRP and TNF-α level in 2 groups were significantly lower than before； the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Amlodipine besylate combined with lisinopril and hydrochlorothiazide， atorvastatin in the treatment of primary hypertension complicating with carotid atherosclerosis can effectively control the blood pressure level， delay the progression process of carotid atherosclerosis， reduce the inflammatory reaction degree， but dose not increase the occurrence of ADR with good safety.