Hypertension is a prevalent problem in kidney transplant recipients that is known to be a “traditional” risk factor for atherosclerotic cardiovascular disease leading to premature allograft failure and death. Donor, peritransplant, and recipient factors affect hypertension risk. Blood pressure control after transplantation is inversely associated with glomerular filtration rate (GFR). Calcineurin inhibitors, the most commonly used class of immunosuppressives, cause endothelial dysfunction, increase vascular tone, and sodium retention via the renin-angiotensin-aldosterone system resulting in systemic hypertension. Transplant renal artery stenosis is an important, potentially treatable cause of hypertension. According to the large observational studies, it is reasonable to achieve a blood pressure goal of equal to or less than 130/80 mmHg in the long-term follow-up for minimizing the cardiovascular morbidity. The selection of antihypertensive agents should be based on the patient’s co-morbidities; however, the initial choice could be calciumchannel blockers especially in the first few months of transplantation. Dihydropyridine calcium channel blockers mitigate calcineurin inhibitor nephrotoxicity and may be associated with improved estimated GFR. In patients with cardiovascular indications of renin-angiotensin-aldosterone system inhibition, given the well-described benefits in diabetic and proteinuric patients, it is reasonable to consider the use of renin-angiotensin-aldosterone system inhibitors. The use of ß-blockers may be associated with improved patient survival, even for patients without cardiovascular disease. Meanwhile, over the past few decades, the shortage in the kidney donor pool as compared to the increasing number of candidates on the kidney transplant waitlist led to loosening of kidney donors’ acceptance criteria. Some transplant centers accept Caucasian living donors with well-controlled hypertension on a single agent if they agree to close follow-up. Living donation may increase blood pressure by 5 mmHg or more and hypertension itself represent risk factors for chronic kidney disease, both in native kidneys and those in kidney transplant recipients. While great progress has been made in kidney transplantation from living donors to benefit the recipient survival and quality of life, progress has been slow to fully risk-characterize the donors. In this presentation, I will review the clinical effects of hypertension in both donors and recipients and to suggest appropriate treatment based on the published guidelines and evidences.