Renovascular hypertension is an unusual complication of renal trauma, occurring in approximately 5% of cases. It occurs predominantly in young males following road traffic accidents (RTA) or blunt abdominal trauma. The interval between injury and development of hypertension varies from two days to 14 years but presentation may be acute with hypertensive encephalopathy. Hypertension developing within a few months of injury may be treated conservatively. Conservative treatment more than one year after injury is associated with an increased risk of persistent hypertension. All cases of renal trauma should be followed with regular blood pressure (BP) recording for at least the first year after injury.