Objective: To investigate the effect of butylphthalide capsule combined with donepezil on the expression of cytokines, matrix metalloproteinase (MMP)-9, homocysteine ??(Hcy) and superoxide dismutase (SOD) in patients with senile vascular dementia (VD). Methods: In the paper, 102 elderly patients with VD were selected and divided into control group and treatment group by random number table method, 51 cases in each group. The control group was given oral donepezil, and the treatment group was given oral butylphthalide capsules on the basis of donepezil. The treatment course of the two groups was 12 w. In the paper, the total effective rate of the two groups after 12 wk of treatment was compared; Changes in SOD levels and adverse reactions. Results: The total effective rate in the treatment group was significantly higher than that in the control group (P < 0.05). After 12 wk of treatment, the scores of daily living ability scale (ADL) in the two groups were higher than those before treatment, while the scores of clin. dementia rating (CDR) scale were lower than those before treatment, and the difference was statistically significant (P < 0.05); w ADL score was significantly higher than that of the control group, while CDR scale score was significantly lower than that of the control group (P < 0.05). The Hasegawa Dementia Scale (HDS) score and Mini Mental State Scale (MMSE) score at 12 wk after treatment in the two groups were significantly higher than those before treatment (P < 0.05); and the treatment group was significantly higher than the control group (P < 0.05) . The serum levels of TNF-α, IL-6 and IL-18 in the two groups after treatment for 12 wk were significantly lower than those before treatment (P < 0.05); and the treatment group was significantly lower than the control group (P < 0.05). The levels of serum MMP-9 and Hcy in the two groups at 12 wk of treatment were significantly lower than those before treatment, while the levels of SOD were significantly higher than those before treatment (P < 0.05); and the levels of serum MMP-9 and Hcy in the treatment group at 12 wk of treatment were significantly lower than those in the control group. The SOD level was significantly higher than that in the control group (P < 0.05). There was no statistical difference in adverse reactions between the two groups (P > 0.05). Conclusion: Butylphthalide capsules combined with donepezil had good curative effect on elderly patients with VD, and could reduce the levels of cytokines TNF-α, IL-6 and IL-18, reduce the levels of MMP-9 and Hcy, and increase the level of SOD.