Hypertension is the major modifiable risk factor that increases the likelihood of cardiovascular events and target organ damage in PAD patients. This chapter discusses the critical role of hypertension in peripheral arterial disease (PAD) and aortic diseases, focusing on the diagnosis, management, and treatment strategies, and summarising current relevant guidelines. The chapter provides guidelines on blood pressure measurement, emphasising the importance of both office and out-of-office monitoring to ensure accurate diagnosis and treatment. In brief, blood pressure targets for PAD patients should generally range between 120 and 140 mm Hg systolic and below 80 mm Hg diastolic, although higher targets are acceptable for elderly and frail individuals. Treatment approaches include lifestyle modifications, such as weight loss and increased physical activity, combined with pharmacological therapies. First-line medications typically include angiotensin-converting inhibitors or angiotensin receptor blockers, calcium channel blockers and thiazide diuretics, with combination therapy recommended for most patients. Special considerations are necessary for PAD patients due to the complex relationship between blood pressure control and cardiovascular risk, particularly in cases of critical limb ischaemia. The chapter concludes by underscoring the need for tailored hypertension management in PAD patients to balance the risks of both high and low blood pressure, and it highlights gaps in current research that future studies may address to optimise treatment outcomes for this high-risk population.