Blood pressure elevation is a vital sign among children and adolescents than previously thought. The prevalence of hypertension in adolescents far exceeds the numbers who are diagnosed; studies done so far, have found that 75% or more goes undiagnosed. Documentation of elevated Blood Pressure readings at three or more well child visits has been found to greatly improve the chances of a correct diagnosis. Guidelines for the screening for and diagnosis, evaluation, and management of hypertension in children have been available for 40 years. Unfortunately, clinicians repeatedly fail to acknowledge the problem and therefore majority of hypertensive children remain undiagnosed. Several reasons for this are documented: including lack of knowledge of the problem and the complexity of blood pressure standard readings among children.