Objective：To investigate the change between serum homocysteine（Hcy） and tumor necrosis factor-α（TNF-α），inter－leukin-6（IL-6），plasma endothelin（ET） and nitric oxide（NO） in patients with elderly hypertension and their correlation，and to investigate the mechanism of Hcy in the elderly hypertension from the perspective of immune inflammatory factor and vascular endothelial factor. Methods：The serum Hcy，TNF-α，IL-6，ET and NO in 177 patients with elderly hypertension were tested，and patients were divided into the group Q1，the group Q2 and the group Q3 according to serum Hcy concentration. One-way ANOVA was used to analyze the difference of parameters among three groups. The correlation between Hcy and TNF-α，IL-6，ET and NO was analyzed by Pearson correlation coefficient. Binary Logistic regression was used to analyze the particular impact of Hcy on TNF-α，IL-6，ET and NO. Results：Hcy，TNF-α，IL-6 and ET in the group Q2 and group Q3 were significantly higher than those in the group Q1，while NO was significantly decreased（all P<0.05）. Pearson correlation analysis showed that Hcy was positively correlated with TNF-α，IL-6 and ET（r values were 0.676，0.852 and 0.730 respectively） and was negatively correlated with NO（r=-0.637），with statistically signif－icant difference（all P<0.05）. After correcting other factors，logistic regression analysis showed that Hcy was a risk factor for elevation of TNF-α，IL-6 and ET（all P<0.05），and was a protective factor for NO elevation（P<0.05）. Conclusion：Serum Hcy and TNF-α，IL-6，ET and NO in patients with elderly hypertension has correlation. The high Hcy may lead to immune inflammation damage and vascu－lar endothelial dysfunction，and then participate in the pathologic process of elderly hypertension.