Resistant hypertension is one of the most common chronic diseases today. Despite the advanced medical knowledge and therapeutic possibilities, blood pressure in 10 to 30% of hypertensive population is above target values with concurent use of three different antihypertensive medications, one of which is a diuretic. In order to confirm the diagnosis of resistant hypertension, pseudoresistance and possible secondary causes of hypertension need to be ruled out. 24-hour ambulatory blood pressure monitoring is recommended to confirm resistant hypertension, and it is especially useful for its capacity to assess nocturnal blood pressure. These patients require thorough medical evaluation and the assessment of target organ damage because of their high cardiovascular risk. Pharmacological treatment must be prescribed in optimal doses based on the current guidelines. If their blood pressure remains above target values despite adequate treatment, patients should be referred to a hypertension specialist or considered for modern endovascular methods. Based on the estimations, around 1% of hypertensive patients will develop a hypertensive crisis. According to the 2013 ESC/ESH guidelines, hypertensive crisis is comprised of two different entities, hypertensive urgency and emergency, based on the presence of end-organ damage. It is necessary to differentiate if the patient is presenting with hypertensive urgency or emergency because of the considerable differences in their treatment. Patients with hypertensive emergency should be treated in the intensive care unit with short-acting antihypertensive drugs given parenterally. The choice of drugs depends on the nature of end-organ damage. The main goal of hypertensive crisis treatment is to carefully and gradually reduce blood pressure therefore avoiding hypoperfusion. Follow-up, lifestyle changes and compliance evaluation are important in order to minimize cardiovascular risk in all hypertensive patients.