The case of a 63-year-old patient in whom serious hypertension of recent onset was recalcitrant to conventional anti-hypertensive therapy is reported. Clinical and biohumoral data suggested a form of nephro-vascular hypertension. This clinical case led to a review of the clinical and diagnostic criteria of this by means rare form of secondary hypertension. The correctness of the diagnostic and therapeutic approach was confirmed by the normalisation of plasma renin levels and by the good control of arterial pressure after right nephrectomy (rendered indispensable after the angiographic finding of complete stenosis of the right renal artery).