OBJECTIVES Renal denervation (RDN) is a new treatment option for patients with uncontrolled resistant hypertension. Studies have shown RDN to have a potential reduction in systolic blood pressure and therefore reduce risk for different cerebro-cardiovascular disease (stroke, ischemic heart disease, heart failure, etc.). The aim is to assess the economic impact of renal denervation in resistant hypertensive patients based on the potential clinical benefit demonstrated in literature. METHODS A budget impact model was developed to quantify RDN-related cost-savings accomplished through lower rate of cerebro-cardiovascular events compared with the medical treatment cohort (with 3+ anti-hypertensive medications including a diuretic). The model was developed from the Italian National Healthcare Service (NHS) perspective with a 10-year time horizon. The risk of events was calculated using different multivariate equations. A literature review was carried out to collect the treatment costs for both acute and chronic phase of hypertension-related events. The cost of RDN procedure was approximated to the related DRG tariff. RESULTS Renal denervation, considering the blood pressure reduction observed after procedure, substantially reduces cerebro-cardiovascular event probabilities by 30% if compared to the medical treatment cohort. Assuming a yearly 2% RDN adoption rate, approximately 2,000 events would be avoided in 10 years allowing total savings up to 9 Million euro. The higher cost of new technology was offset from potential saving associated to the avoided events. Compared to the total costs associated to the medical treatment cohort in 10 years the overall expenditure for RDN was greater than 0.8%. The annual incremental cost for patients treated with surgical approach was estimated at 16 euro per patient. CONCLUSIONS The economic impact of hypertension-related complications is significant in the Italian setting. Consequently the potential savings according to the NHS perspective derived from the implementation of strategies aimed at improving the level of hypertension should be considered.