A rapid, simple and specific liquid chromatography-electrospray ionization mass spectrometry method has been developed and validated for the determination of hydroxyzine hydrochloride in human plasma. Samples were separated using a Thermo Hypersil-HyPURITYC18 reversed-phase column (150 mm × 2.1 mm i.d., 5 μm). The mobile phase consisted of 50 mM ammonium acetate (pH 4.0)–methanol–acetonitrile (45:36:19, v/v). Hydroxyzine and its internal standard were measured by electrospray ion source in positive selective ion monitoring mode. The method was validated with a linear range of 1.56–200.0 ng mL⁻¹ and the lowest limit of quantification was 1.56 ng mL⁻¹ for hydroxyzine hydrochloride (r ²= 0.9991). The extraction efficiencies were about 70% and recoveries of the method were in the range of 93.5–104.4%. The intra-day relative standard deviation (RSD) was less than 8.0% and inter-day RSD was within 7.4%. QC samples were stable when kept at ambient temperature for 12 h at −20 °C for 30 days and after four freeze–thaw cycles. The method has been successfully applied to the evaluation of pharmacokinetics and bioequivalence of two hydroxyzine hydrochloride formulations in 12 healthy Chinese volunteers after an oral dose of 25 mg.