OBJECTIVES: Hypertension represents a major health problem, affecting more than 1 billion adults worldwide. Irbesartan, an angiotensin II receptor blocker, is considered to be a highly effective treatment in the management of hypertension. Therefore this study aims to evaluate the efficacy, safety and tolerability profile, as well as the cost-effectiveness of irbesartan in the treatment of hypertension METHODS: A review of the literature was conducted using the electronic databases Medline, Cochrane and HEED of search terms relating to irbesartan efficacy, tolerability and cost-effectiveness and the results were synthesized.   RESULTS: Findings from the present analysis show that irbesartan either as monotherapy or in combination with other agents can have significant reductions in Blood Pressure, both systolic and diastolic, when compared to other alternative treatment options. Irbesartan was also found to have a renoprotective effect, independent of its blood pressure lowering effect in patients with type 2 diabetes and nephropathy. Irbesartan also delayed onset of end-stage renal disease (ESRD) and reduced the cumulative incidence of ESRD.  Furthermore, Irbesartan demonstrated an excellent safety and tolerability profile. Overall adverse event incidence with irbesartan was comparable with other antihypertensive drugs. Most common adverse events were headache, fatigue and dizziness. In terms of economic analyses, compared to other antihypertensive therapy alternatives, irbesartan increased life expectancy and lead to substantial cost savings.  CONCLUSIONS: Evidence indicates that treating patients with hypertension alone or with type II diabetes and nephropathy, can control hypertension, prolong life and reduce costs, in relation to other existing alternatives.