Abstract: Objective To explore the effect of Shengmai powder combined with tilt training on the curative effect and prognosis of the elderly patients with vasovagal syncope (VS) in Cardiology Department. Methods Total 80 patients with VS in Xixi hospital between 2015 and 2017 were enrolled into this study and randomly divided into two groups with 40 cases in each group. The control group was given routine symptomatic treatment, while the observation group was additionally given Shengmai powder combined with tilt training treatment, the course was 3 months in both group. The results of sublingual nitroglycerin tilt table test, the levels of plasma catecholamine and the changes in hemodynamics were compared before and after the treatment. All patients were followed up to observe the side effects of drugs and recurrent rate of VS. Results In the observation group, the systolic pressure, diastolic pressure and heart rate before the tilt table test did not changed obviously after the Shengmai powder combined with tilt training treatment (P>0.05), however, the systolic pressure, diastolic pressure and heart rate when syncope or at end of the tilt table test elevated obviously after the treatment (P<0.05). Before the treatment, there was an obvious increment in the levels of plasma epinephrine and norepinephrine when syncope as compared with those at supine (P<0.05); however, after the treatment, there was no significant difference (P>0.05). After 3 months of treatment, HUTT test negative rate in the observation group was significantly higher than that in the control group, there was significant difference (P<0.05); Six months follow-up showed that the recurrence rate and the average time of syncope were significant differences between the two groups (P<0.05). Conclusion Shengmai powder combined with tilt training for senile vasovagal syncope can improve hemodynamics, reduce plasma catecholamine levels, reduce syncope episodes, prevent the recurrent of syncope. It is worthy of promotion.