Abstract: Objective To observe the effect of repeated transcranial magnetic stimulation combined with conventional anti-dementia treatment in treatment of elderly patients with vascular dementia(VD). Methods A total of 190 elderly patients with VD were divided into study group and control group according to random number table method, with 95 cases in each group. The control group received conventional anti-dementia treatment, and the study group received repeated transcranial magnetic stimulation on the basis of the control group. The clinical effects and incidence of adverse reactions were observed. Cognitive function by Mini-mental State Examination(MMSE)score, dementia condition by Hasegawa Dementia Rating Scale(HDS)score, daily living ability by Activities of Daily Living(ADL)score, quality of life by Stroke Specific Quality of Life(SS-QOL)score and serum tumor necrosis factor-α(TNF-α), caspase-3, lipid peroxide(LPO), matrix metalloproteinase-9(MMP-9), and angiotensin-Ⅰ(Ang-Ⅰ)levels before and after treatment were compared between the two groups. Results The total effective rate of the study group was higher than that of the control group(P<0.05). The MMSE, HDS, ADL, and SS-QOL scores in the study group were higher than those in the control group after treatment(P<0.05), and serum levels of TNF-α, Caspase-3, LPO and MMP-9 in the study group were lower than those in the control group, and serum Ang-Ⅰ level was higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the study group and the control group(P>0.05). Conclusion - Repeated transcranial magnetic stimulation on the basis of conventional anti-dementia treatment can further down-regulate the expression levels of serum Caspase-3, TNF-α, LPO and MMP-9, increase level of Ang-Ⅰ, significantly improve the cognitive function, relieve the degree of dementia and effectively improve the prognosis of elderly VD patients. It has significant effect and higher safety.