Sodium nitroprussid as a form of sodium salt that has been known since ancient times as a drug that lowers blood pressure. Today its use is found in various conditions such as hypertensive crisis, hypertensive encephalopathy, acute heart failure, prevention of „no reflow“ phenomena during PCI, and so on. Hypertensive crisis can be divided into two stages. The first is mild, when the patient is hemodynamically stable, and blood pressure is reduced by oral medications. The other is sever, when the patient is often hemodynamically unstable and it is necessary to quickly start lowering blood pressure, but with a note that must be gradual. In that case, we can use sodium nitroprusside or some other intravenous vasodilator. More and more papers and research give green light for the use of sodium nitroprusside in the prevention and treatment of „no reflow“ phenomenon, which is lack of flow after stent implantation, which only exacerbates the irreversible changes in cardiomyocytes. Although sufficiently researched, it is believed that in the near future it will be able to be used in conditions such as no reflow. In acute heart failure, especially if it is caused by elevated blood pressure and hypertensive crisis, we use diuretics, morphine, etc. and also sodium nitroprusside to lower blood pressure as soon as possible. But it is necessary to note that this is a very important timely diagnostic and treatment due to the high death rate.