Objective To investigate the possible relative factors for cognitive function impairment in the elderly with hypertension. Methods A total of 200 hypertensive patients with age over 60 were investigated by the trained physicians. The investigation was given to all the subjects one by one to assess the prevalence rate of cognitive impairment by Mini-mental state examination (MMSE) and Clock Drawing Test (CDT). At the same time, their other related information was analyzed. Results The prevalence of cognitive impairment was 29.5% (59/200) in the cohort. The univariate analysis showed that the following factors affected cognitive function in patients with hypertension: age, sex, education level, alcohol consumption, regular exercise, hypertension controlling and diabetic history. Multivariate logistic regression analysis on above 7 factors revealed that risk factors were age (OR＝1.769, 95% CI 1.014-3.087), hypertension controlling (OR＝2.159, 95% CI 1.358-3.434) and diabetes (OR＝3.925, 95% CI 2.070-12.961), while the protective factors were education level (OR＝0.145, 95% CI 0.058-0.364) and regular exercise (OR＝0.197, 95% CI 0.070-0.555). Conclusion Cognitive impairment is influenced by many factors in the elderly with hypertension. Senior age, poor hypertension controlling and diabetes will increase the risk of cognitive dysfunction, while, higher education level and keeping regular exercises will protect them from cognitive impairment.