Aim To study the detection of carotid artery intima plaque in elderly hospitalized patients with hypertension and its influencing factors. Methods A total of 328 elderly hypertensive patients were selected,and color Doppler ultrasound was used to detect all patients' carotid artery intima plaque and grading.Patients' sex,age,the course of hyperpiesia,the controls of high blood pressure in the past,the smoking history,family history of hypertension,history of stroke and other messages were noted by clinical records. Results The detection rate of carotid artery intima plaque was 77.4%,in which class 1,class 2 and 3 accounted for 32.0%,36.9% and 8.5%(plague score).Ordered Logistic regression univariate cumulative analysis showed that male,old,poorly controlled blood pressure,longer duration of hypertension were risk factors for plaque.Multivariate analysis showed that the major risk factors for plaque were male,old age and poor control of blood pressure. Conclusion Hypertension in the elderly patients with higher rate of carotid artery intima plaque,and male patients,old age,patients whose blood pressure was in poor control were the high-risk groups.