Aim To discuss the curative effect and protection of Pracachol on carotid atherosclerosis. Methods 120 patients with carotid atherosclerosis and hyperlipaemia were randomly divided into treatment group and control group. The treatment group were treated with Pracachol 10 mg/d and their carotids and lipid level were checked after 3, 6 and 12 months in order to compare with the control group on the numbers and types of their carotid atheromatous plaques,carotid inner diameters (D), the thickness between carotid intima-media thickness (IMT). Results 3 months' treatment with Pracachol can decrease total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC) level in plasme efficiently, and as the treatment prolonged, the decrease of plaques'numbers, the change of plaques' type and the dinilution of IMT all has Statistcal significance. Conclusions Pracachol can decrease the lipid level in plasma efficiently, and to some extent, it can improve and stabilize the carotid atheromatous plaque as well.