Hypertension in neonates is no longer a rare entity due to improved methods of surveillance, increased vigilance on the part of clinicians, and as a complication of the technologies employed in neonatal intensive care units. Although good broad-based normative blood pressure data in preterm and term neonates is not available, the existing literature allows us some guidelines for defining hypertension. The multiple etiologies and clinical presentations are discussed, as well as a practical approach to evaluation. Pharmacologic management is presented, including some of the newer drugs. With aggressive management, the prognosis for resolution of hypertension in almost all instances is excellent; however, it remains to be seen what, if any, long-term effects will occur.