Hypertensive emergency is an acute, perilous state connected with a marked increase of peripheral vascular resistance and the decrease of tissue perfusion. Its development depends on the rate of blood pressure elevation, on the severity of developed hypertension and the state of the vascular system. Although hypertensive emergencies can be grouped also on symptomatological and etiological basis, regarding the therapeutic measures to be taken, they appear in two well distinguishable forms. In case of hypertensive crisis treatment has to be started without delay, possibly in a few minutes, in states involving the risk of hypertensive crisis treatment has to be initiated within a few hours to avoid extensive damage of the vital organs or fatal outcome. The acute, but controlled reduction of blood pressure must not surpass 15-25% of the medium value. In hypertensive crisis, if possible, parenteral medication--as first aid--urapidil, verapamil, in states with endangering hypertensive crisis sublingual nifedipine, captopril, nitroglycerin may be applied, however in the different emergency states therapeutic intervention has to be individually determined.