Abstract：Objective：To observe the clinical effect and safety of atorvastatin calcium combined with Guanxinning tablets for carotid atherosclerotic plaque. Methods：A total of 98 cases of patients with carotid atherosclerotic plaque were selected for prospective study，and were randomly divided into the study group and the control group，49 cases in each group. The control group was treated with atorvastatin calcium tablets，and the study group was additionally treated with Guanxinning tablets based on the treatment of the control group. Both groups were treated for three months. The changes in intima-media thickness(IMT) and maximum plaque areas in carotid artery as well as in the levels of triglyceride(TG)，total cholesterol(TC)， high density lipoprotein- cholesterol(HDL- C)，low density lipoprotein- cholesterol(LDL- C) before and after treatment in the two groups were observed and compared； the clinical effect and the adverse reactions in the two groups were counted. Results： The total effective rate was 97.96% in the study group and 89.80% in the control group， the difference being significant(P＜0.05). Before treatment， there was no significant difference being found in the comparison of IMT and the maximum plaque areas between the two groups(P＞0.05). After treatment，IMT and the maximum plaque areas in the two groups were decreased when compared with those before treatment(P＜0.05)，and IMT and the maximum plaque area in the study group were thinner or smaller than those in the control group(P＜0.05). Before treatment， when compared levels of TG ，TC，HDL-C，and LDL-C between the two groups，there was no significance being found in the difference(P＞0.05). After treatment， levels of TG， TC， and LDL- C in the two groups were decreased when compared with those before treatment(P＜0.05)， and HDL- C level in the two groups were increased(P＜0.05)； the improvement of the four indexes above in the observation group was more significant than that in the control group(P＜0.05). The incidence of adverse reactions was 6.12% in the study group and 2.04% in the control group，there being no significant difference between the two groups(P＞0.05). Conclusion： Atorvastatin calcium combined with Guanxinning tablets can significantly reduce carotid plaques and improve blood lipid levels with good safety.