This chapter delves into identifying and managing hypertensive crises, characterized by blood pressures exceeding 180/110 mmHg. It emphasizes the importance of recognizing hypertensive urgencies, often marked by mild symptoms but lacking end-organ damage, and contrasts them with hypertensive emergencies where immediate intervention is required due to potential organ damage. Common inpatient triggers include medication nonadherence, excessive IV fluids, and stress-related factors. While hypertensive urgencies might seem benign in the short term, they pose significant long-term cardiovascular risks. The chapter provides guidance on the appropriate clinical approach, highlighting the importance of accurate blood pressure measurement and the need for follow-up to ensure optimal long-term management. It also advises against the routine use of IV antihypertensive medications in non-emergent situations.