OBJECTIVES: Hypertension is a major risk factor for stroke and myocardial infarction (MI), which imposes a substantial burden on patients, caregivers, and society. Despite the high financial burden, limited studies have examined the cost-effectiveness of hypertension treatments in Taiwan. This cost utility analysis was conducted to determine the costs and quality-adjusted life years (QALYs) associated with amlodipine (CCB) and valsartan (ARB) in preventing stroke and MI among Taiwanese hypertension patients.  METHODS: A Markov model was developed, consisting of six states including alive without stroke/MI, MI, post-MI, stroke, post-stroke, and death. We estimated the costs and QALYS of amlodipine and valsartan in a five-year time period. Effectiveness data were based on a published meta-analysis. Costs of drugs, direct medical costs of hypertension management, stroke/MI treatment, and follow-up management were included. All costs inputs were based on either published literature or an expert survey. Utility data were retrieved from published literature. Discounting rate used for both costs and QALYs was 3% and currency reported in 2014 US dollar (US$1 = 30 Taiwanese dollar). Third-party payer perspective was applied. RESULTS: Based on the hypothetical cohort of 10,000 hypertension patients, total costs for amlodipine and valsartan users were US$7,969,402 and US$13,169,296 respectively. Total QALYs was 30,648.5 for amlodipine users and 30,520.8 for valsartan users. Compared to valsartan, amlodipine had an incremental cost of -US$5,199,894 with 127.7 QALYs gained. Results remained consistent from various sensitivity analyses. CONCLUSIONS: For hypertension patients in Taiwan, amolodipine is a cost-saving treatment with better outcomes in preventing stroke and MI in comparison with valsartan. It lowers the acute care costs associated with stroke and MI as well as costs of follow-up disease management.