Objective: Hypertension is called the silent killer and vital organs such as the brain, eyes, kidneys and the heart are the targets. Seizure, central nervous system (CNS) hemorrhage, and cerebrovascular accident (CVA), blindness and heart attacks are the end points. The prevalence of hypertension in children is much less than adults, but evidence reveals that he source of hypertension in adulthood goes back to childhood. In 70-80% of cases hypertension is due to renal diseases. In children, hypertensive encephalopathy (HE) may be the first manifestation of renal diseases. Seizure is one of the most common manifestations of HE. In this article, definitions, etiology, pathophysiology and finally the acute and chronic managements of HE will be discussed.