Hypertensive emergencies represent one of the most common presentations to the emergency department, as many as 3% of visits in one study. For emergency physicians, early diagnosis and appropriate treatment are essential for minimizing injury due to elevated blood pressure. In some cases, this management of hypertension can be life saving. This Newsletter focuses on the drug treatment of hypertensive emergencies, primarily parenteral therapy. The drugs of choice for the treatment of each diagnostic category are discussed with the evidence supporting these recommendations.