Hypertension has the largest prevalence of all cardiovascular risk factors in the general population (roughly 30-45%). The specific mortality from cardiovascular diseases in developed countries amounts to about 50% of the general mortality. Therefore, the achievement of blood pressure values below 140/90 mmHg is considered one of the main methods of achieving high long term patient quality of life. Nevertheless, a substantial number of patients do not achieve target blood pressure values in spite of taking at least three antihypertensive medications in adequate dosage of which one is a diuretic. Although the most common causes of therapeutic failure are undiscovered secondary causes of hypertension and lack of patient compliance, in about 10% of cases it can be attributed to resistant hypertension caused by a hyperactivity of the sympathetic nervous system. Catheter-based renal denervation is a novel minimally invasive method of treating resistant hypertension by reducing the overall sympathetic drive via selective ablation of nerve fibers within the walls of renal arteries. Initial observational studies have shown that renal denervation is a safe and effective method of reducing office blood pressure in patients with resistant hypertension, along with a positive effect on blood glucose regulation, heart and kidney function, obstructive sleep apnea and signs of hypertensive end organ damage. Even though this method is promising, criticism is directed at inadequately designed mostly observational studies without 24h ambulatory blood pressure measurement records, coupled with a significant variability in patient response to therapy. That is why it is important to conduct randomized controlled trials to finally assess the effectiveness of renal denervation and the influence it might have on reducing cardiovascular morbidity and mortality, along with constructing clear guidelines as to which patients would have the most benefit.