Abstract: Objective To investigate clinical characteristics of autonomic dysfunction (AD) in hypertensive patients with minor ischemic stroke (MIS). Methods Sixty hypertensive patients with MIS (observation group) and 60 age-matched hypertensive patients (control group) were recruited in our study. The clinical data of the patients were collected. Autonomic symptoms were accessed using the Scale for Outcomes in Parkinson disease-Autonomic (SCOPA-AUT). Depression was evaluated with Hamilton Depression Scale (HAM-D) . Age, heart beat rate, concomitant diseases, SCOPA-AUT, and HAM-D were analyzed between the two groups. Results Compared with the control group, the observation group showed an increased incidence of orthostatic hypotension, depression, SCOPA-AUT and HAM-D score. Logistic regression showed HAM-D score>8 〔standard partial regression coefficent (β)=0.142, odds ratio (OR)=3.251, P=0.009〕 and age>60 yr. (β=0.180, OR=1.972，P=0.003) were independent risk factors for AD. Conclusion AD is common in hypertensive patients with MIS and depression is probably the potential etiology.