Background: Asian Indians account for one-fifth of all cardiovascular deaths worldwide. It is well known that hypertension is a major risk factor for cardiovascular mortality and morbidity, but there has been no national survey for estimating the prevalence of hypertension in the Indian population. Hypertension in this ethnic group is less well studied than hypertension in blacks or Caucasians. Methods: We searched PubMed and MEDLINE using the words “Asian Indians” “hypertension” “blood pressure” “epidemiology” “prevalence” “prevention” “treatment” as search items and went through the major Indian journals to gather sufficient data regarding hypertension in Asian Indians. Most of the data was acquired from studies conducted in India, as there are only limited studies on Indians who have settled overseas. Results: High prevalence of hypertension was found in the urban Indian population as compared to the rural Indian population, while there was inconsistent data on migrant Indians. The modern Indian diet and lifestyle may be responsible for the urban - rural differences. Large proportion of Indian population is unaware of their condition and significant proportion of them is pre-hypertensive. No specific treatment guidelines for this ethnic group are available. Conclusion: The escalating incidence of hypertension among Asian Indians in urban India is alarming. This will likely add to the already existing cardiovascular disease burden in this ethnic group and it is imperative to conduct additional epidemiological and clinical studies to assess the prevalence, pathogenesis, and optimal pharmacotherapy of hypertension in Asian Indians. Aggressive screening and treatment regimen should be adopted considering the risk of untreated and sub-optimally treated hypertension and specific guidelines for treatment of hypertension in Asian Indians appears warranted.