Abstract: Objective To investigate the effects of physical activity ability on cognitive function in elderly patients with hypertension. Methods From August 2015 to May 2016, a total of 1 508 elderly hypertension patients were randomly selected from 28 community health service centers/township health centers in Wuhan city. Physical activity scale for the elderly（PASE） was used to assess the physical activity, including leisure physical activity, household activity and occupational physical activity. The mini-mental state examination（MMSE） was used to assess the cognitive function of patients. Results Multivariate unconditioned Logistic regression analysis showed that more physical activity, high education level and good exercise habit were protective factors for cognitive function, while age and waist-to-height ratio were risk factors for cognitive function. Cognitive function was related to gender, which was worse in female than in male. No significant correlation was found between cognitive function and smoking, body mass index, grade of blood pressure, hypertension combined with diabetes, coronary heart disease and hyperlipidemia（P＞0.05）. After detailed classification of physical activity, multivariate linear regression analysis showed that cognitive function was positively correlated with sitting exercise, walking or going out, moderate physical activity, strenuous physical activity, and occupational physical activity. The correlation between cognitive function and sitting exercise, walking or going out was the most obvious（β=0.185, 0.191; all P＜0.05）. Cognitive function was not correlated with mild physical activity, activities to increase muscle strength and housework activities（P＞0.05）. Conclusion More physical activity is a protective factor for cognitive function in elderly patients with hypertension. The correlation is the most obvious between cognitive level and sitting exercise, walking or going out.