Objective To explore the effect of conversation map health education based on medication literacy on medication safety in community elderly patients with hypertension. Methods A total of 80 elderly patients with hypertension in the community were selected by convenience sampling method and divided into the control group and the interventiongroup according to the random number table method, with 40 cases in each group.The control group carried out routine community health education, while the intervention group implemented conversation map health education based on medication literacy. After 8 weeks of intervention, the scores of medication safety, medication errors and medication literacy were compared between the two groups. Results A total of 39 cases in the control group and 33 cases in the intervention group completed the study.After intervention, there were statistically significant differences in the total score and each dimension score of medication safety, and the total score and each dimension score of medication literacy between the two groups (all P<0.05). There were statistically significant differences in the total score of medication errors and the scores of 7 items such as prescription errors, omission errors, time errors, dose errors, self-purchase drugs, self-withdrawal drugs, and monitoring errors between the two groups (all P<0.05). Conclusion Conversation map health education based on medication literacy can improve the medication safety level, medication errors and medication literacy of elderly patients with hypertension in the community.