Abstract: Objective To explore the effect of Huangqi Buxue Decoction combined with Salvia Miltiorrhiza and Ligustrazine Injection in the treatment of elderly patients with H-type hypertension complicated with acute cerebral infarction. Methods Totally 131 elderly patients with H-type hypertension complicated with acute cerebral infarction were randomly divided into two groups, 65 cases in the control group were treated with Salvia Miltiorrhiza and Ligustrazine Injection, and 66 cases in the observation group were treated with Huangqi Buxue Decoction on the basis of the control group. The therapeutic effect, blood pressure, homocysteine(Hcy)level, hemorheology indexes, nerve function indexes and drug safety were compared between the two groups. Results After treatment, the blood pressure and Hcy level of the observation group were significantly lower than those of the control group(P<0.05). The hemorheology indexes of the observation group were significantly lower than those of the control group(P<0.05). The National Institutes of Health Stroke Scale(NIHSS)score of the observation group was significantly lower than that of the control group, the Barthel index and Fugel-Meyer(FMA)score of the observation group were significantly higher than those of the control group(P<0.05). The incidence of adverse reactions in the control group was 7.69%, which showed no significant difference compared with 6.06% in the observation group(P>0.05). Conclusion Huangqi Buxue Decoction combined with Salvia Miltiorrhiza and Ligustrazine Injection can effectively reduce blood pressure and Hcy level in patients with H-type hypertension complicated with acute cerebral infarction, improve hemorheology, alleviate the nerve function damage, and improve the daily - living ability and motor function of patients.