Aim To investigate the relationship between osteoporosis and atherosclerosis in elderly hypertensive patients. Methods 149 patients （≥60 yesrs old，average age 72.7±10.1 yesrs old）were included, whose bone mineral density and brachial-ankle pulse wave velocity（BaPWV） were measured by dual energy X ray bone density and Doppler ultrasonography. Among them,109 patients with hypertension were used as the case group and 40 patients without hypertension were used as the control group. Results The neck bone mineral density, greater trochanter bone mineral density and the total hip bone mineral density were significantly lower in patients with hypertension group than the control group, and the difference was statistically significant（P<0.05）. The neck bone mineral density, greater trochanter bone mineral density, intro bone mineral density, total hip bone mineral density were significantly lower in patients with high BaPWVL group than the low BaPWVL group, and the difference was statistically significant（P<0.05）. After controlling the age, the bone mineral density was negatively correlated with the left BaPWV（r－0.191 and －0.199,P<0.05）,and the difference was statistically significant. Logistic regression analysis show that age and apolipoprotein B were risk factors for atherosclerosis. Conclusion Hypertension is a risk factor for osteoporosis. Increased arterial stiffness is associated with reduced bone mineral density in hypertensive patients. Therefore, hypertensive patients with increased arterial stiffness may have a high risk of bone fracture due to osteoporosis.