To explore the effect of Tongxinluo and Atorvastatin on carotid atherosclerotic plaque and blood lipid. Methods: Selected 67 patients with carotid atherosclerotic plaques, randomly divided into 3 groups, i.e. Atorvastatin group, Tongxinluo group and combination group (Atorvastatin + Tongxinluo), observed 12 weeks. Carotid artery intima - middle thickness, plaque area, plaque integral and changes in blood lipids were observed. Results: Each treatment group’s carotid artery IMT and plaques area was decreased and total plaque score lowered after treatment (P <0.01). Comparison between groups regarding carotid IMT and plaque area and the total score: Atorvastatin + Tongxinluo group was better than the single drug groups with statistical difference. Atorvastatin group was significantly better (P<0.05) than Tongxinluo group except for plaques total score (P>0.05). Combination group TC TG, LDL - C declined greater than other groups (P<0.05). Tongxinluo group TG declined significantly after treatment (P<0.05). TAtorvastatin group showed better effect on TC TG, LDL - C difference (P<0.05), and Tongxinluo group was better to reduce TG (P<0.05). Conclusion:Atorvastatin in combination with Tongxinluo has better curative effect on carotid intima - middle thickness, plaque area, plaque score and blood lipids than monotherapy.