Objective To evaluate the clinical effects of amlodipine on structure and function of atherosclerotic artery in elderly hypertensive patients. Methods The intima-media thickness(IMT) and the inner diameter of carotid artery at rest and overpressure of brachial artery as well as after sublingual nitroglycerin administration were measured with amlodipine by color Doppler ultrasonograms before and after long-term (36 months) treatment. The hypertensive patients (76 cases) were divided into 3 groups according to the value of IMT. Group A, n = 21, IMT +1s. Results The blood pressure was controlled to therapeutic aim and maintained stable after 8 weeks treatment with amlodipine. The carotid artery IMT of hypertensive patients was lowered significantly and the endothelium-dependent vasodilative function of common carotid artery was improved dramatically after 36 months therapy with amlodipine. The IMT and endothelium-dependent vasodilative function came up to normal standards in group A and approached the normal level in group B. Conclusions Amlodipine can improve the endothelium-dependent vasodilative function, retard or even reverse the progression of carotid artery IMT, when it lowers blood pressure stably.