Abstract: Objective: To observe the relationship between homocysteine changing and carotid artery ultrasound in patients with hypertention or also with hypertention and DM. Methods: sixty one normal elder people,eight six elder patients with hypertention, thirty four patients with hypertention and DM were checked blood lipid、homocysteine and carotid artery ultrasound. Results: （1） carotid artery abnormality and homocysteine obviously higher in patients with hypertention and DM.（2）carotid artery abnormalitys’ blood lipid and homocysteine were higher.（3）homocysteine was higher in patients with multiple branchs carotid artery abnormality、in patients with hypertention or in patients with hypertention and DM than the simple branch carotid artery abnormality or the normal elders. Conclusion: hypertention and DM increased abnormality of carotid artery in elder people,with high blood lipid and hyperhomocysteine more increaseing carotid artery disease.