Objective To investigate the influence of hypertension with impaired glucose tolerance (IGT) on the risk of all-cause mortality in the elderly males. Methods The study included the elderly males with IGT and normal glucose tolerance (NGT) detected by oral glucose tolerance test in the Chinese PLA General Hospital from May 2005 to May 2007. According to the baseline history, they were divided into four groups (NH+NGT, H+NGT, NH+IGT, and H+IGT) and followed up at least once a year. SPSS statistics 13.0 was used for data analysis and Cox regression model for the analysis of the differences in all-cause mortality risk between the four groups. Results Compared with the NH+NGT group, the risk of incidental type 2 diabetic mellitus in the H+IGT group (HR=2.55,95%CI 1.56-4.16; P<0.001) and the NH+IGT group (HR=2.40,95%CI 1.35-4.25; P=0.003) significantly increased. Univariate Cox proportional hazard regression indicated that the risk of all-cause mortality in the H+IGT group (HR=2.59,95%CI 1.34-5.01; P=0.005) was significantly higher than the NH+NGT group, while there was no significant difference in H+NGT group and NH+IGT group as compared with NH+NGT group (P>0.05). After adjustment of related risk factors at baseline, multivariate Cox proportional hazard regression showed that the trend of all-cause mortality risk in H+IGT group (HR=1.83,95%CI 0.90-3.70; P=0.095) still increased as compared with NH+NGT group (P>0.05). Conclusion Hypertension with impaired glucose tolerance is closely associated with the risk of all-cause mortality in the elderly males. The coexistence of hypertension and IGT can further increase the risk of all-cause mortality.