Abstract: Objective To investigate the effect of rosuvastatin intervention on blood lipid level, carotid artery plaque and cerebral ischemic events in patients with hypertension and carotid atherosclerosis. Methods A total of 255 hypertensive patients with carotid plaques in our hospital between May, 2013 and May, 2015 were prospectively included, and randomly divided into control group, low dose rosuvastatin group (observation group 1) and routine dose group (observation group 2), with 85 cases in each group. All the three group were given antihypertensive therapy and lifestyle intervention, while the control group received 1 tablet of placebo which had the same the appearance of rosuvastatin, the observe group 1 received rosuvastatin 5 mg/day, and the observe group 2 received rosuvastatin 10 mg/day. The follow up was 6 months. Before and after the treatment, the blood lipids levels, blood pressure and carotid artery intima media thickness (IMT), plaque area and Crouse plaque score were detected. The incidence of ischemic events after 6 months of treatment was compared. Results The indexes of the control group showed no significant difference before and after treatment (P > 0. 05);after treatment, the systolic blood pressure and diastolic blood pressure observation of group 1 and observation group 2 decreased compared with prior treatment, but there was no statistical significance (P > 0. 05); the level of TC, LDL-C in Observation group 1, Observation group 2 was declined than before; the level of IMT, plaque area, Crouse plaque score, The rate of vulnerable plaque were elevated than before, with statistical significance (P < 0. 05). The index improvement is obvious in Observation group 2 than Observation group. Conclusion In addition to hypolipidemic effects, Rosuvastatin can also reverse and stabilize the plaque, reduce the incidence of ischemic stroke, and is positively correlated with the dose.