Aim To explore the impact of atorvastatin on clinical efficiency and endothelial function of aged patients with unstable angina pectoris. Methods 120 cases with unstable angina pectoris were randomly divided into control group and observation group. The control group was treated by conventional therapy,the observation group received atorvastatin 20 mg additionally. The treatment duration was 12 weeks. Before and after treatment,the endothelial vasodilation function was determined by color Doppler flow imaging,fasting venous blood was collected to detect blood lipid and nitric oxide （NO）,the clinical efficiency was compared between the two groups. Results For the observation group,after treatment,the levels of total cholesterol （TC）,triglyceride （TG）,high density lipoprotein cholesterol （HDLC）,low density lipoprotein cholesterol （LDLC） and NO,the degree of brachial artery flow mediated dilatation improved greatly （P<0.05）,the clinical efficiency of angina pectoris and cardiograph was 86.7% and 76.7%,respectively there were significant differences between two groups （P<0.05）. Conclusion Atorvastatin treatment could effectively alleviate the patients with unstable angina pectoris,its treatment effect may be related to the improvement of blood lipid and endothelial function.