Abstract: Objective To investigate the prognostic value of exercise combined with 24-hour ambulatory blood pressure monitoring (ABPM) in the elderly hypertensive patients. Methods Forty-five patients over 60 years old were asked to perform submaximal exercise with controlled symptoms according to modified Bruce protocol to detect exercise-induced hypertension, followed by ABPM. Results The blood pressure of all the patients was within normal range, but the exercise induced the peak blood pressure reached 211.98±9.37 mmHg/101.50±12.86 mmHg. Fourteen patients with exercise-induced hypertension conformed to the diagnosis of hypertension according to ABPM, who had significantly higher measurements in ABPM than the normotensive patients (P<0.001). Conclusion Exercise test combined with ABPM may help identify hypertension in early stage in elderly patients.