This article discusses the pathophysiologic features, diagnosis, treatment, and management of patients with renovascular hypertension. Timely diagnosis is important as the disease can carry a more serious prognosis than essential hypertension and is less amenable to drug treatment. Renovascular hypertension also carries a greater risk of progression to accelerated or malignant hypertension and may result in irreversible ischemic failure of the affected kidney. Various treatments are available including medical management, angioplasty and/or stenting, and revascularization. Regardless of treatment approach, nursing care is an integral part of the patient's management, especially continuing follow-up of blood pressure.