Objective To determine the plasma levels of homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the elderly patients with masked hypertension. Methods A total of 60 elderly in-patients (over 65 years old) with masked hypertension confirmed by ambulatory blood pressure monitoring admitted in our department and Midong District Branch from January 2012 to October 2013 were recruited in this study as masked hypertension group. Another 60 elderly individuals without masked hypertension who took physical examination in our hospital during same period served as control group. The gender and age well matched between two groups. Plasma levels of Hcy, hs-CRP and IL-6 were detected in all the patients, and the results were compared between the 2 groups. Results The plasma level of Hcy was significantly higher in the masked hypertension group than in the control group [(17.64±7.94) vs (11.03±5.35)mmol/L, P＜0.01]. The masked hypertension group also had obviously higher plasma hs-CRP [(0.61±0.15)mg/L and IL-6 levels (0.20±0.05)mg/L] than the control group [(0.50±0.14)mg/L and (0.16±0.04)mg/L respectively, P＜0.05]. Conclusion Plasma levels of Hcy, hs-CRP and IL-6 are higher in elderly masked hypertensive patients than in those without masked hypertension. Whether Hcy, hs-CRP and IL-6 be involved in the pathogenesis of the elderly masked hypertension needs further study.