OBJECTIVE： To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS： 78 patients with geriatric depression with anxiety were randomly divided into control group （39 cases） and observation group （39 cases）. Control group received 20-40 mg Paroxetine hydrochloride tablet， within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy， HAMD， HAMA and TESS before and after 2， 4 and 8 weeks of treatment in 2 groups were observed. RESULTS： The total effective rate in observation group was significantly higher than control group， the difference was statistically significant （P＜0.05）. HAMD after 4 and 8 weeks， HAMA after 8 weeks in control group， HAMD and HAMA after 2， 4 and 8 weeks in observation group were significantly lower than before， and it gradually decreased by time prolonged， observation group was lower than control group， the differences were statistically significant （P＜0.05 or P＜0.01）. And there was no significant difference in the TESS rating in 2 groups before and after treatment （P＞0.05）. CONCLUSIONS： The efficacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety， with better safety.