Abstract： Objective To study the application of intensive reduction of blood pressure to the treatment of acute cerebral hemorrhage in elderly patients. Method From January 2006 to December 2007, 40 elderly patients with acute cerebral hemorrhage were enrolled in a randomized and controlled study. Patients were randomly divided into intensive blood pressure reduction group and control group in equal number ( n = 20). The antihyper-tensive agent was used intravenously to reduce the systolic blood pressure to the level lower than 140 mmHg within 1 hour after treatment in patients of intensive blood pressure reduction group, and then the blood pressures was maintained for 7 days.The blood pressure of patients in control group was reduced to that just under 180 mmHg. The size of the haematoma was measured before and 3 days after treatment. The Stroke Scale set by the American National Institutes of Health (NHISS) was assessed before and 7 days and 28 days after treatment,separately. The modified Rankin Scale (mRS) was used to assess the patients 90 days after treatment. The outcomes were statistically analyzed with SPSS version 16.0 software. Measurement data were analyzed with t -test while numeration data were analyzed with chi-square test. Results Before and 3 days after treatment, there was significant difference in size hematoma between two groups (P < 0.05) . Between before and 7 days after treatment, there was significant difference in NHISS scale in intensive blood pressure reduction group (P < 0.05), but there was no significant difference in control group (P > 0.05). Before and 28 days after treatment, there was significant difference in variance of NHISS scale between two groups ( P < 0.05) . Nineth days after treatment, there was significant difference in mild disability and severe disability between two groups ( P < 0.05) . Conclusions Intensive reduction of blood pressure is valid for the treatment of elderly patients with acute cerebral hemorrhage.