OBJECTIVE: To observe the clinical effects of essential hypertension treated with acupuncture at Siguan [Hegu (LI 4) and Taichong (LR 3)], Quchi (LI 11) and Xingjian (LR 2). METHODS: Sixty cases of essential hypertension were randomly divided into an acupuncture group and a medication group, 30 cases in each group. Two groups of acupoint, which were (1) Siguan [Hegu (LI 4) and Taichong (LR 3)] and (2) Quchi (LI 11), Xingjian (LR 2), were selected alternatively in the acupuncture group, once everyday. In the medication group, captopril was prescribed for oral administration 25 mg per time, three times per day. Seven days made one session in both groups and totally three sessions were required. RESULTS: (1) After treatment, the blood pressure were decreased significantly in the two groups (all P < 0.01). Compared with the medication group, the diastolic pressure after 14 days, 21 days of treatment in the acupuncture group was decreased significantly (both P < 0.01). (2) In the terms of TCM syndrome score, the improvement of dizziness, soreness and weakness of waist and knees, palpitations was significant in the acupuncture group compared with that in the medication group(all P < 0.05). (3) The acupuncture group had less adverse reactions compared with the control group (P < 0.05). CONCLUSION: Acupuncture at Hegu (LI4) and Taichong (LR 3), Quchi (LI 11) and Xingjian (LR 2) can effectively decrease blood pressure; the effect of controlling diastolic pressure is better than captopril. It can also improve the symptoms of dizziness, soreness and weakness of waist and knees, and palpitations.