Objective: Cochrane reviews were considered as evidence of highest quality for evidence-based decision-making. WHO has applied Cochrane reviews in selection of essential medicines. Here, we assessed whether Cochrane reviews are effective for selection of essential medicines in China. Methods: We searched the most recent Chinese essential medicines list, and used antihypertensive medicines as examples in our study. We searched the Cochrane Library for reviews that specifically address effects of these medicines. Results: Nine antihypertensive medicines were identified, including captopril, enalapril, sodium nitroprusside, magnesium sulfate, nitrendipine, indapamide, phentolamine, and two compound reserpine tablets. The search identified 25 Cochrane reviews; only 3 reviews, however, specifically addressed the effects of these individual medicines. The other reviews typically assessed the effects of a class of medicines (e.g. ARB, diuretics). One study showed that captopril and enalapril were effective in lowering systolic and diastolic pressure compared to placebo; no evidence of direct comparison of these two medicines was reported. Another study suggested that magnesium sulphate was ineffective in reducing blood pressure and had significant adverse effects. The third review concluded that reserpine was more effective, relative to placebo, in reducing systolic blood pressure. Conclusion: Limited evidence can be available to assist in selection of essential medicines. Some Cochrane reviews that typically assess drug class effect compared with placebo may not address comparative effectiveness of individual medicines.