OBJECTIVE： To investigate the effects of 3 types of antihypertensive drugs on cognitive function in elderly hypertensive patients after acetabular surgery. METHODS： Ninety hypertensive patients receiving antihypertensive drugs for a long term （not changed antihypertensive drugs within 2 weeks before surgery） undergoing selective acetabular surgery were included sequentially and divided into angiotensin receptor blocker （ARB） group， angiotensin converting enzyme inhibitor （ACEI） group and  calcium channel blocker （CCB） group according to the types of antihypertensive drugs， with 30 cases in each group. All patients received acetabular surgery under epidural anesthesia. The cognitive function of patients was evaluated by using MMSE 1 d before surgery （T0）， 1 d after surgery （T2） and 3 d after surgery （T3）. The concentration of S100β protein serum was determined 1d before surgery （T0）， immediately after surgery （T1） and 1 d after surgery （T2）. RESULTS： Compared with T0， MMSE score of ARB group at T2， those of ACEI group and CCB group at T2 and T3 were decreased significantly， with statistical significance （P＜0.05）. Compared with ARB group， MMSE score of ACEI group and CCB group at T2， T3 were decreased significantly， with statistical significance （P＜0.05）. Compared with ACEI group， MMSE score of CCB group at T2， T3 were decreased significantly， with statistical significance （P＜0.05）. Compared with T0， the concentration of S100β protein serum in serum 3 groups were increased significantly， with statistical significance （P＜0.05）. Compared with ARB group， the concentration of S100β protein serum in ACEI group and CCB group were increased significantly， with statistical significance （P＜0.05）. Compared with ACEI group， the concentration of S100β protein serum in CCB group at T1， T2 were increased significantly， with statistical significance （P＜0.05）. The incidence of cognitive dysfunction was in ascending order of ARB group （30％）＜ACEI group （43％）＜CCB group （57％）. The incidence of cognitive dysfunction in CCB group was significantly higher than in ARB group， with statistical significance（P＜0.05）. CONCLUSIONS：Antihypertensive drugs can improve the cognitive function in elderly hypertensive patients after acetabular surgery. The incidence of cognitive dysfunction in the patients taking ARB is the lowest， better than ACEI and CCB.