Objective: To explore the effects of Niuhuang Qingxin Pill on serum inflammatory factors and neurotransmitters in elderly patients with hypertension-induced vertigo accompanied by anxiety and depression.Methods: 122 elderly patients with hypertensive vertigo with anxiety and depression were divided into an observation group (n=61) and a control group (n=61). The control group was given conventional Western medicine treatment, while the observation group was given Niuhuang Qingxin Pill on top of that. All were treated for 7 days. The changes in TCM syndrome scores, Self-Rating Anxiety Scale (SAS) scores, Self-Rating Depression Scale (SDS) scores, ECG function [Standard deviation of all NN intervals (SDNN), root mean square of successive RR interval differences (rMSSD), percentage of all successive RR interval differences greater than 50ms (pNN50), very low frequency power (VLF)], blood pressure, inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], and neurotransmitters [5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA)] levels were observed in both groups before and after treatment. The clinical efficacy and adverse reactions of the two groups of patients were compared.Results: After 7 days of treatment, the total effective rate of the observation group was 91.80%, while that of the control group was 75.41%; the clinical efficacy of the observation group was higher than that of the control group (P0.05). After 3 months of follow-up, there were no delayed adverse reactions in the two groups; the incidence of recurrent hypertension vertigo, anxiety progression, and depression progression in the observation group was lower than that in the control group (P<0.05).Conclusion: Niuhuang Qingxin Pills can effectively inhibit the level of inflammatory factors, up-regulate the level of neurotransmitters, control blood pressure, improve neurological function, relieve vertigo, anxiety, depression, and other clinical symptoms in the treatment of elderly patients with hypertensive vertigo with anxiety and depression. The curative effect is remarkable, it can maintain the medium and long-term curative effect, and the safety is reliable.