Hypertension is one of the most frequently encountered systemic diseases in patients visiting the dental clinics, due its high prevalence worldwide. It has been attributed to approximately 7.1 million deaths per year, having a prevalence of approximately 1 billion.While managing a hypertensive patient in the dental office, the dentist must take efforts to perform the dental procedures with optimum pain control, stress and anxiety reduction. Admininistration of dental local anaesthesia with epinephrine in these patients is considered risky. This article highlights the precautions to be taken during management of a hypertensive patient in the dental office. Furthermore, it is cardinal that the dentist should master the protocols of treatment and management of complications in hypertensive patients.