Abstract: Objective To investigate the curative effect of repetitive transcranial magnetic stimulation(r TMS) in the treatment of treatment-resistant depression and the cognitive function of patients. Methods The clinical data of patients with treatment-resistant depression in our hospital from January 2013 to December 2014 were reviewed. The patients in the observation group received escitalopram oxalate tablets and r TMS treatment,while the patients in the control group was given escitalopram oxalate tablets combined invalid stimulation treatment by r TMS. The curative effect was compared between the two groups. The change of the level of BDNF,NE and 5-HT of the patients before and after the treatment were analyzed,and the correlation with HAMD score was performed. Results After 4 weeks of treatment,the total efficiency of the observation group was 87. 5%,of the control group was 27. 78%,Wilcoxon rank sum test showed that the total effective rate of the observation group was significantly higher than that in the control group(U=4. 86,P < 0. 001); 2 and 4weeks after the treatment,HAMD scores in the observation group was significantly lower than rate in the control group(t=2. 358,P=0. 021 vs. t=3. 594,P < 0. 001); The serum NE(t=3. 544,P < 0. 001),5-HT(t=4. 821,P < 0. 001),BDNF(t=2. 171,P=0. 331) in the observation group was significantly higher than those in the control group,the difference had statistical significance(P < 0. 05); 4 weeks after the treatment,the serum NE,5-HT and BDNF in the observation group showed significant negative correlation with HAMD scores(r=- 0. 512,- 0. 683,- 0. 624,P < 0. 05). Conclusion Low-frequency r TMS can obviously improve the clinical symptoms of treatment-resistant depression,with a good effect,which can help patients recover the cognitive function. It can be used widely in clinic.