Hypertension is a common disease in the community, mostly primary hypertension, patients are often asymptomatic except for occasional dizziness and headache, and can be treated with oral medication in the community. In contrast, acute hypertension is a critical condition in which the blood pressure rises sharply within a short period of time and causes target organ dysfunction, requiring hospitalization and treatment with intravenous antihypertensive drugs under cardiac monitoring. The condition is seen not only in patients with secondary hypertension such as pheochromocytoma, renal failure, and alcohol withdrawal, but also in patients with long-term poor control of primary hypertension and sudden discontinuation of medication. Therefore, timely detection and referral of hypertensive emergencies is also a topic that community physicians need to face. In general, patients with hypertensive emergencies have significantly elevated blood pressure [diastolic blood pressure often reaches 110 mm Hg (14.6 kPa) or higher] and have progressive impairment of brain, eye, heart, kidney and other organ functions, severe headache, blurred consciousness, blurred vision, fundus bleeding, angina pectoris, left heart failure, entrapment aneurysm, and deteriorating kidney function. GPs facing hypertensive patients with these manifestations must be vigilant and monitor them more closely. If necessary, they should be referred to the hospital for consultation and treatment as soon as possible.