Aim To observe the therapeutical effect of atorvastatin taken orally together with antihypertensive medicine on visual electrophysiological changes in patients with hypertensive retinopathy (HR). Methods 238 patients with essential hypertension complicated with retinopathy were enrolled in the study, and were randomly divided into atorvastatin group (132 cases) and the conventional treatment group (106 cases). The patients of two groups were given the same oral antihypertensive medicine. On the basis, the patients in the atorvastatin group were treated with atorvastatin.The changes of flash electroretinogram (FERG) a-wave, b-wave and oscillatory potential (OP) were observed and compared before and after 6,2, 24 months of treatment in the two groups. Results In the two groups, after treatment, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower than those before treatment (P＜0.001), FERG a-wave, b-wave, OP and the wavelets latent periods were significantly shortened (P＜0.05 or P＜0.001), the amplitudes were significantly prolonged (P＜0.05 or P＜0.001), and the longer the duration, the greater the difference.Compared with the same period conventional treatment group, blood pressure, blood lipid and body mass index could be effectively controlled in atorvastatin group (P＜0.05 or P＜0.001), but blood pressure decline did not significantly correlate with the lipid-lowering effect (P＞0.05). 12 months after drug use, compared with conventional treatment group, FERG a-wave, b-wave, OP and the wavelets latent periods were significantly shortened (P＜0.05 or P＜0.01), the amplitudes were significantly prolonged (P＜0.05 or P＜0.01) in atorvastatin group, and 24 months after drug use, the above differences were more obvious (P＜0.01 or P＜0.001). Principal component Logistic regression analysis showed that the decrease range of SBP, DBP, total cholesterol, low density lipoprotein cholesterol and the application of atorvastatin were the main factors influencing the improvement of visual electrophysiology in patients with HR (P＜0.05 or P＜0.001). Conclusion Atorvastatin therapy on the basis of conventional anti-hypertensive drugs can obviously improve the effect in the treatment of HR with the improvement of visual electrophysiology.