Objective To investigate the correlation of high homocysteine (Hcy) hypertension (H-type hypertension) with serum levels of uric acid (UA) and fibrinogen (FIB) in the elderly. Methods A total of 251 elderly in- and out-patients with essential hypertension admitted in our department from January 2013 to January 2014 were recruited in this study. They were divided into H-type hypertension group [n＝121, serum Hcy level ≥15μmol/L] and primary hypertension group (n＝130, serum Hcy level＜15μmol/L). Another 150 elderly individuals without hypertension taking physical examination in our hospital during same period served as controls. Serum levels of Hcy, UA and FIB were detected in all the patients, and the results were compared among different groups. Results For the H-type hypertension, primary hypertension and control groups, there were statistical differences in the levels of UA [(320.97±106.61), (280.74±71.27) and (261.01±71.80μmol/L)] and FIB [(3.22±0.52), (3.05±0.52) and (2.68±0.41)g/L] between any of the 2 groups (P＜0.01). Logistic regression analysis showed that H-type hypertension was positively correlated with the serum level of UA (OR＝3.896) and FIB (OR＝3.100) and with the reduced level of folic acid (OR＝2.776, all P＜0.05). Conclusion H-type hypertension is closely associated with UA and FIB. Monitoring their levels is of great significance in the management of H-type hypertension in the elderly.