The use of alternative therapies, herbs, and supplements occurs at a very high rate among patients attending a variety of health care settings. Such therapy may cause significant interactions or effects on hypertension and other cardiovascular disorders and needs to be considered by clinicians. In this brief review, we highlight several commonly used alternative therapies that may have a clinical impact in the hypertensive patient. Several problems hinder our complete awareness of these effects. These problems include patients not informing physicians about alternative treatment or herbal use, the lack of consistent scientific standards for the bioactivity of many herbals or supplements, and the multiple names that each bioactive substance is sold under. Specific questioning regarding herbals and alternative therapies in the hypertension clinic is therefore needed. Herbals including ma huang, St. John's wort, yohimbine, garlic, and licorice all may cause important consequences in the hypertensive patient. Added care is needed in monitoring the use and effects of herbal and alternative therapies in the hypertensive population.