Objective To study the efficacy and safety of donepezil in the treatment of post-stroke aphasia.Methods Patients with post-stroke aphasia were randomly divided into twogroups: donepezil treated and control (n=38, each). The control group received a conventional treatment. Beside the conventional treatment, the patients in treated group were given 5 mg donepezil once a day for 4 weeks. The language function of patients was evaluated by western aphasia battery (WAB) and aphasia quotient (AQ).Results The WAB and AQ scores in the two groups increased after treatment. The WAB scores (oral expression, auditory comprehension and retelling) in the donepezil treated group were significantly higher than those in the control group (P<0.05) 4 weeks after treatment. Donepezil had obvious effects on retelling in speech disorders of anandia, sensoryaphasia and conduction aphasia, but anomicaphasia. No significant adverse effects of donepezil were observed.Conclusions Donepezil is effective and safety in the treatment of post-stroke aphasia.