Recently, a number of studies have found an association between low birth weight and fetal growth retardation, with the risk of elevated blood pressure and hypertension in adulthood. This paper reviews this literature with particular reference to Africa. There appears to be an inverse relationship between birth weight and blood pressure; this has been observed in adults and children. Among adolescents and infants, however, the findings have been inconsistent. In Africa, although this apparent association may be obscured by undiagnosed and unreported hypertension, differential low birth weight mortality and lower levels of longevity and obesity, it may provide a partial explanation for the rapidly increasing prevalence of hypertension on the continent.