• Severe hypertension occurred in three young patients (ages 14, 15, and 25 years), apparently as a sequel to bilateral stenosis of the renal arteries. In two the stenosis was orificial and due to fibrous intimal proliferation; in the other, the oldest patient, it was associated with severe calcific atherosclerosis of the renal artery and aorta. The fatal course of the condition in two of the patients clearly demonstrated the need for correction of the renal arterial circulatory impairment. This experience led to recognition of the condition in the third patient and to relief of the hypertension by what is believed to be the first successful arterial homografting of both renal arteries. This condition may represent a hitherto unrecognized syndrome of hypertension in adolescence and may result from a developmental defect in the formation of the renal arteries.