The first choice of drugs for hypertensive emergencies should take into account their complications and the actual patient’s clinical performance to select the optimal antihypertensive drugs. At present, the four drugs that are relatively preferred clinically are nitroglycerin, nicardipine, labetalol and sodium nitroprusside. These four drugs are relatively fast-acting and have a strong antihypertensive effect. Nitroglycerin is used in patients with acute hypertension with acute heart failure, or acute coronary syndrome. Adverse reactions include tachycardia, headache, vomiting, facial flushing, etc. Nicardipine is relatively more suitable for hypertensive emergencies combined with acute cerebrovascular disease, or other hypertensive emergencies. Adverse reactions include tachycardia, facial flushing, etc. Labetalol is relatively indicated for patients with hypertensive emergencies combined with pregnancy or renal insufficiency. Adverse reactions include dizziness, upright hypotension, and heart block. Sodium nitroprusside can directly dilate veins and arteries and reduce the anterior and posterior cardiac load, and can be used in all types of hypertensive emergencies. Adverse reactions are relatively mild and can occur with nausea, vomiting, and muscle tremors.