Dental implant surgery has developed into a widely used procedure for dental rehabilitation and is a secure and predictable procedure. Local and systemic factors can result in higher failure rates. Hypertension is a chronic disease that goes in with atherosclerosis, and coronary artery disease which causes multifarious side effects. Hypertension as a relative contraindication for implant surgery is controversially discussed. Because the number of patients suffering from hypertension increases, therefore more hypertensive patients demand implant procedures. We also conclude that patients with poorly controlled blood pressure suffer from impaired osseointegration, elevated risk of peri-implantitis, and a higher level of implant failure. The influence of the disease is not fully clear. The supportive administration of antibiotics and chlorohexidine seems to improve implant success. When hypertension is under well control, implant procedures are safe and predictable with a complication rate similar to that of healthy patients.