In this study, 67 cases of renovascular hypertension were followed from one to six years after vascular repair or nephrectomy. Twenty-five patients became normotensive and another 30 patients showed significant improvement. There were 18 failures and three deaths in this series. The results obtained in this series were compared with those obtained from other centers and have been analyzed in regard to the percentage of cases treated by nephrectomy versus those treated by arterial reconstruction procedures. The data indicate certain pitfalls in the preoperative diagnosis of renovascular hypertension, employing the currently available tests of radiorenography, intravenous urography, and divided kidney studies.