Renal artery stenosis has a high incidence and is one of the most common causes of refractory or intractable hypertension. According to foreign data, about 20% of all hypertensive patients have combined renal artery stenosis. The clinical consequences of renal artery stenosis are usually severe: stenosis greater than 50% can affect renal perfusion, and stenosis greater than 70% significantly reduces renal blood flow, causing activation of the renin-angiotensin system, resulting in increased renin secretion, increased angiotensin and serum aldosterone, further increasing peripheral vascular resistance, increased water and sodium retention, and increased arterial blood pressure. Severe stenosis can also lead to progressive kidney damage, renal atrophy and loss of renal function, and is an important cause of acute left heart failure (commonly known as acute pulmonary edema) in the elderly. According to foreign data, about 1/3 of elderly patients with acute left heart failure have a combination of renal artery stenosis. Renal artery stenosis is usually caused by atherosclerosis, fibromuscular anomalies of the renal arteries, and aortitis. Other rare factors such as renal artery thrombotic/embolic disease, aortic aneurysms, and neurofibromas can also cause renal artery stenosis and occlusion. Younger patients with renal artery stenosis are most often caused by renal artery fibromuscular dysplasia and aortitis, while atherosclerosis is the main cause of renal artery stenosis in the elderly. In young hypertensive patients (less than 30 years old), especially those with a history of aortitis, myxomatous dysplasia of the arteries and other immune diseases, they should be highly alert for the presence of renal artery stenosis, and outpatient clinics should routinely perform renal artery ultrasound or renal CT enhancement for such patients; in middle-aged and elderly patients, if blood pressure is recently found to be elevated, or if it is difficult to control, taking ACEI or In the middle-aged and elderly, if there is a recent increase in blood pressure, a progressive deterioration in renal function on ACEI or ARB, or a transient acute pulmonary edema, renal artery ultrasound or renal CT enhancement should be strongly recommended to clarify the combination of renal artery stenosis. Although conventional methods such as renal artery ultrasound or renal CT are helpful in screening and diagnosing renal artery stenosis, renal arteriography remains the gold standard for confirming the diagnosis. According to domestic experience and in conjunction with US guidelines for the diagnosis and intervention of renal artery stenosis, renal arteriography should be performed in the following patients (1) hypertensive patients younger than 30 years of age; (2) those who present with renal impairment or renal volume reduction, especially on ACEI or ARB; (3) those with renal artery stenosis suggested by renal artery ultrasound or renal CT; (4) those with proposed diagnosis of renal artery fibromuscular dysplasia or the presence of aortitis; (5) patients aged >60 years with recent hypertension, especially in combination with diabetes mellitus or patients with coronary artery disease at high risk of atherosclerosis; (6) patients aged >60 years with episodes of unexplained nocturnal paroxysmal dyspnea (acute left heart failure) without organic heart disease hypertension; (7) refractory hypertension in which other secondary factors are excluded. Given the serious clinical consequences of renal artery stenosis, the presence of severe renal artery stenosis once diagnosed should be treated aggressively to facilitate blood pressure control, delay or reverse renal damage, and prevent or reduce the occurrence of acute pulmonary edema. The most effective treatment for renal artery stenosis is interventional therapy, which is not only less invasive and has a high success rate (99% technical success rate) but also has a low complication rate (<4< span="">% serious complication rate for occlusion of the main renal artery, perforation, and nephrectomy). According to current guidelines, intervention (balloon angioplasty + renal artery stenting) should be performed when R70% of renal artery stenosis is confirmed by imaging. Only in the rare cases of long-lasting renal artery occlusion with significant atrophy and loss of function of the kidney, surgical approach is used to remove the lost kidney.