Introduction/ Background: Hypertension (HTN) has emerged as a modern epidemic and is at raising trend globally and will continue to be in future . Hypertensive crisis is an urgent situation in the emergency department and presents with various clinical patterns. Hence, present study was an attempt to create awareness regarding various risk factors leading to hypertensive crisis along with their timely prevention and to subsequently reduce mortality and morbidity associated with it. Objective: To create awareness regarding various risk factors leading to hypertensive crisis along with their timely prevention and to subsequently reduce mortality and morbidity associated with it. Material and Method: Prospective observational study was undertaken in Rohilkhand Medical College and Hospital, Bareilly including 100 patients admitted in the ICU from 1st Jan 2018 to 31st Dec 2018. Detailed clinical examination including measurement of blood pressure and routine investigations were done. The data was expressed as means ± SEM and was statistically analyzed. Results: Total 100 cases were enrolled in the study, of which 72 were of HTN –Emergency (HTN–E) and 28 were HTN– Urgency (HTN–U) with mortality of 6%. Breathlessness was most common presentation followed by stroke ,chest pain, headache , dizziness , nasal bleed, vomiting , palpitation , decreased urine output , psychomotor agitation. In HTN– U most common presentation was dizziness followed by headache and nasal bleed whereas in HTN– E breathlessness followed by stroke and chest pain was observed in our study. The most common target organ which was affected was retina followed intracranial haemorrhage and heart failure. Conclusion: The prevalence of hypertensive crisis is 1.86% in our study with mortality of 6%. In HTN– U most common presentation was dizziness followed by headache and nasal bleed whereas in HTN – E , breathlessness followed by stroke and chest pain was observed in our study. Management of hypertensive crisis can be challenging and requires intensive care. Early detection and timely intervention subsequently reduces mortality and morbidity associated with it.