Objective To explore the predictive value of mean platelet volume-platelet ratio (MPVPCR) and mean platelet volumelymphocyte ratio (MPVLR) in obstructive sleep apnea hypopnea syndrome (OSAHS) with hypertension. Methods This study is a retrospective study. Patients from January 1, 2018 to January 1, 2021, 109 with OSASH in the cardiology department of our hospital were collected. According to whether the patients had hypertension, they were divided into a simple OSASH group and hypertension group. We compared the general baseline data of the two groups. Besides, we analyzed the correlation between OSAHS and hypertension and baseline data using spearman's correlation analysis. Finally, we analyzed the predictive value of MPVPCR and MPVLR in OSAHS with hypertension using receiver operating characteristic curve (ROC). Results Compared with the simple OSAHS group, the combined hypertension group had significant differences in the apnea-hypopnea index (AHI), the longest apnea time (LAT), minimum blood oxygen saturation (MinSaO 2）), lymphocyte count, platelet (PLT), MPVPCR and MPVLR levels (P＜0.05). The correlation showed that higher levels of AHI, LAT, MPVPCR and MPVLR were positively correlated with the risk of OSAHS hypertension (P＜0.05), while higher lymphocyte count and platelet levels were negatively correlated with the 〖HJ〗risk of OSAHS hypertension. (P＞0.05). ROC curve analysis showed that the AUCs of MPVPCR and MPVLR alone and in combination to predict the occurrence of hypertension in OSAHS were 0.686, 0.742 and 0.819, respectively. Conclusion Compared with the OSAHS group alone, the OSAHS combined with hypertension group has longer AHI and LAT, and higher levels of MPVPCR and MPVLR; MPVPCR and MPVLR are independent predictors of the risk of hypertension in patients with OSAHS, and the combination of the two is more valuable.