Aim. To assess moexipril clinical efficacy, safety, and target organ protection in postmenopausal women. Material and methods. An open, randomized, non-comparative trial involved 32 postmenopausal women (mean age 63.17±0.87 years), with arterial hypertension (AH) mean duration of 10.4±2.3 years, Sixteen-week moexipril therapy influence on blood pressure (BP) level (office measurement and 24-hour BP monitoring), vascular function, and microalbuminuria (MAU) in morning urine portion, was investigated. Results. Target BP level was achieved in 29 out of 30 patients: 9 women received 7.5 mg/d of moexipril, 13–15 mg/d, 8–15 mg/d, plus hydrochlorthiazide (12.5 mg/d); 2 women were excluded due to adverse events. Office BP level declined from 164.33±1.45/94.50±0.89 mm Hg to 133.5±0.57/81.5±0.65 mm Hg. In 24-hour BP monitoring, day- and nighttime BP levels decreased, as well as pulse BP, and BP variability. In reactive hyperemia and nitroglycerine tests, vasodilatation increased by approximately 50% and 40%, respectively. MAU significantly reduced from 28.28±3.94 to 8.10±1.00 mg/l (p<0.001). Conclusion. Moexipril therapy demonstrated substantial antihypertensive and organoprotective effects in postmenopausal women with AH, being at the same time metabolically neutral.