Renal denervation as a treatment for hypertension (HTN) has been shown to be effective as a surgical procedure. Over the past 10 years, an endovascular approach to replicate the results of surgical splanchnicectomy has been investigated to replace this surgical procedure with a less invasive procedure with lower morbidity. Several devices and procedures have been developed, including a non-invasive strategy. We review the improvement of HTN in clinical trials of these devices as well as the shortcomings of these studies. Thus far, these trials have been unable to prove that these renal denervation strategies are superior to medical therapy alone, but we look forward to further randomized, double blinded trials of current systems that can effectively achieve denervation to reduce the risk of HTN.