OBJECTIVE： To observe clinical efficacy and safety of escitalopram combined with ozagrel sodium for elderly patients with acute cerebral infarction complicated with anxiety and depression. METHODS： 140 elderly patients with acute cerebral infarction complicating with anxiety and depression were divided into control group and observation group according to random number table method， with 70 cases in each group. Control group received routine treatment and Sodium ozagrel for injection 40-80 mg added into 0.9％ Sodium chloride injection 500 ml， ivgtt， bid. Observation group was additionally given Escitalopram tablet 10 mg， qd. Both groups received treatment for 8 weeks. HAMA， HAMD， NIHSS and BI were compared between 2 groups before and after treatment， and clinical efficacy and the occurrence of ADR were observed. RESULTS： There was no statistical significance in HAMA， HAMD， NIHSS， BI before treatment and NIHSS， BI 1 week of after treatment between 2 groups （P＞0.05）. HAMA and HAMD of observation group 1， 4， 8 weeks after treatment， and NIHSS and BI of it 4， 8 weeks after treatment were improved significantly； above indexes of control group were improved significantly 4， 8 weeks after treatment， and the observation group was better than the control group， with statistical significance （P＜0.05）. The total effective rate of observation group was 87.14％， which was significantly higher than 74.29％ of 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： Escitalopram combined with ozagrel sodium is significantly effective for elderly patients with acute cerebral infarction complicated with anxiety and depression， and can significantly improve anxiety， depression and neurological function with good safety.