<p>Nocturnal hypertension, a critical subtype of hypertension, has garnered extensive attention due to its significant association with increased cardiovascular event risk and all-cause mortality. This review systematically explores the pathophysiology of nocturnal hypertension, encompassing neuroendocrine regulation, renal dysfunction, and sleep disorders, integrating the latest research advancements to provide an in-depth analysis of its pathophysiological basis. Moreover, this review summarizes diagnosis and blood pressure monitoring of nocturnal hypertension, and highlights effective clinical intervention strategies, including pharmacological treatment, lifestyle modifications, and emerging technological approaches, aiming to offer theoretical foundations and practical guidance for clinical diagnosis and management. This review also emphasizes the importance of precise diagnosis and individualized therapy in the management of nocturnal hypertension, underscoring the need for tailored approaches to improve patient outcomes and reduce cardiovascular risk.</p>