Neonatal hypertension, defined as systolic blood pressure greater than 95th percentile for age, size, and gender, is an uncommon but significant problem. Hypertension may develop secondary to thromboembolic complications of central lines, steroid use, or be a sign of an underlying renal or cardiac problem. Pharmacologic management of hypertension in the neonate includes use of beta blockers, angiotensin-converting enzyme inhibitors, calcium channel blockers, and/or diuretics. This article discusses issues in assessment and management of neonatal hypertension and reviews the pharmacologic agents most commonly utilized in the neonatal setting.