Study objective: To determine if the raised blood pressure at an ED visit was due to pain and anxiety or undetected hypertension. Methods: Patients visiting the Emergency department of Max Balaji Super Specialty Hospital, Delhi in a period of 6 months of 2013 were recruited for the study and a sample of 72 patients generated. Patients who passed the inclusion and exclusion criteria had an initial and a repeat ED blood pressure that were increased (SBP e”140 or DBP e”90 mm Hg). To gauge the causality of pain and anxiety in the rise in BP we used an ED Pain score, the Verbal descriptor scale and ED Anxiety score, the Beck’s Anxiety Scale. With 95%CI and 10% precision we enrolled a total of 72 subjects in the study. Results: Out of 72 patients who fulfilled the criteria for study 40.28% were male and 59.72 were female. Average age of the participants was 48 years. Patients with raised ED blood pressure were older and more of females than males. The mean pain score (SD) for the sample was 4.1 and mean (SD) anxiety score was 37.8. Anxiety score showed a positive correlation change in systolic ED blood pressure than diastolic ED blood pressure. Mean (SBP) systolic ED blood pressure at the First reading was Mean 154.6 (SD 6.7) and Second reading was a Mean 128 (SD 9.3).Mean (DBP) diastolic ED blood pressure at the First reading was Mean 94.8 (SD 5.2) and second reading was a Mean 84.15 (SD 6.88). Conclusion:  Even in Indian scenario non- hypertensive patients with raised blood pressure in ED, with pain and anxiety relief still remained in pre-hypertensive stage suggestive for routine reassessment and regular blood pressure follow up with the primary physician and lifestyle modification.