The attitude to treatment of renal artery stenosis has recently been modified from an active to a more expectant strategy based on informations from randomised studies. The primary treatment should be antihypertensive agents. Revascularisation should be considered in patients with refractory hypertension, recurrent pulmonary oedema, bilateral renal artery stenosis or progressive azotaemia, and in patients with a narrow stenosis to a single kidney. The treatment, i.e. surgery or PTA with or without stent, should be selected on an overall view of the patients' health using a combination of clinical, pathophysiological, and angiographic investigations.