Aortic coarctation is a rare cause of secondary hypertension that can lead to vascular complications and early mortality when left untreated. Its clinical presentation is variable depending on the location and severity of obstruction in addition to an individual’s ability to compensate. For many decades now, there have been excellent surgical and interventional therapies that can treat the underlying congenital defect; however, even when treated coarctation patients are at risk for developing late hypertension. Lifelong screening and regular medical follow-up is important to ensure optimal health for this population.