Abstract: Objective: To investigate the relationship between morning blood pressure surge(MBPS)in elderly hypertensives and carotid atherosclerosis.Methods: One hundred and fifteen aged patients with hypertension were performed 24 h ambulatory blood pressure monitoring with monitors.Duppler ultrasonography was used to measure the intima-media thickness(IMT) of carotid and development of plaque.Results: Compared with the nonsurge group,the common carotid artery,internal carotid artery,and carotid bifurcation in MBPS group increased markedly(P<0.01);the detection rate of total plaques in MBPS group were also high(P<0.05).Conclusions: Morning blood pressure surge in elderly hypertensives was an important risk factor for carotid atherosclerosis,cardiovascular incidents would be reduced by intervene MBPS.