Objective: To investigate the relationship between carotid artery damage and blood pressure variability in over 80-year-old essential hypertensive patients. Methods: A total of 64 essential hypertensive patients (≥80 years old) were divided into two groups with or without carotid artery damage by ultrasonography. All patients underwent 24 hour ambulatory blood pressure monitoring, the rate of 24 hour systolic blood pressure variation, 24-hour diastolic blood pressure variation，daytime systolic blood pressure variation, daytime diastolic blood pressure variation，nighttime systolic blood pressure variation, nighttime diastolic blood pressure variation were recorded. Results: The rate of 24 hour systolic blood pressure variation, 24-hour diastolic blood pressure variation，daytime systolic blood pressure variation, nighttime systolic blood pressure variation, nighttime diastolic blood pressure variation were higher in carotid artery damage than that in non- carotid artery damage（p＜0.01、p＜0.01、p＜0.01、p＜0.05和 p＜0.01）. Conclusion: The carotid artery damage correlated with blood pressure variability in over 80-year-old essential hypertensive patients.