Objective To retrospectively analyze the types of blood pressure in children with upright hypertension (OHT) using the 24-h ambulatory blood pressure (ABPM) method. Methods Children who attended or were hospitalized at the pediatric syncope clinic of Xiangya Second Hospital of Central South University from October 2009 to September 2013 with complaints of unexplained syncope and aura syncope, and who were diagnosed with OHT by upright tilt test (HUTT) were selected as the OHT group. ABPM was recorded in both the OHT and control groups. The results were 40 cases in the OHT group, 23 males and 17 females, aged (11.5±1.9) years. In the control group, there were 40 cases, 22 males and 18 females, age (10.6±2.4) years. Comparison of ABPM parameters: diurnal difference in systolic blood pressure was higher in the control group than in the OHT group [(9.84±3.26) vs. (8.37±4.66),P<0.05]. mean systolic blood pressure throughout the day, mean diastolic blood pressure throughout the day, mean daytime systolic blood pressure, mean diastolic blood pressure during the day, mean systolic blood pressure during the night and mean diastolic blood pressure during the night were slightly higher in the OHT group than in the control group (P>0.05). The diastolic blood pressure diurnal difference was slightly higher in the control group than in the OHT group (P>0.05). Blood pressure type: “non-spoon blood pressure” was predominant in the OHT group [29/40 cases (72.5%) vs. 11/40 cases (27.5%)] and “spoon blood pressure” in the control group [22/40 cases (55.0%) vs. 18/40 cases ( 45.0%], and the difference between the two groups was statistically significant (P<0.05). Conclusion Children with OHT have autonomic dysfunction, and the circadian difference of systolic blood pressure is significantly lower than that of normal children, and the type of blood pressure is mostly "non-spoon blood pressure", and the circadian rhythm of blood pressure disappears.