The prevalence of hypertension in the pediatric population is rising, coincident with the rise in childhood obesity worldwide. While most hypertensive children do not require emergent care, hypertensive urgencies and emergencies may be encountered in the outpatient clinic, the emergency department or the inpatient ward. To avoid the life-threatening complications associated with both hypertension and its treatment, the treating physician should be familiar with the presentation and management of pediatric hypertension. This review will serve to examine some of the important aspects of pediatric hypertensive urgencies and emergencies, including common causes, important features of diagnosis and options for medical management.