Hypertension exhibits a winter peak and summer trough in countries both north and south of the equator. A variety of explanations have been proposed to account for the seasonal nature of hypertension. It is likely that this reflects seasonal variations in risk factors. Seasonal variations have been demonstrated in a number of risk factors may play essential roles for seasonality of hypertension such as noradrenalin, catecholamine and vasopressin, vitamin D, and serum cholesterol. However, a number of studies have also suggested a direct effect of environmental temperature and physical activity on blood pressure. This paper was design to review the available evidence on seasonal variations in hypertension and possible explanations for them.