OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of renal denervation (RDN) in resistant hypertensive patients. METHODS: Two reviewers independently screened titles and abstracts for eligibility.  Studies eligible for inclusion in the systematic review of cost-effectiveness were full cost-effectiveness analyses, cost-utility analyses, cost-benefit analyses and cost-consequence analyses. One reviewer performed data extraction, which was checked by two reviewers independently. Two reviewers independently applied quality assessment criteria and differences in opinion were resolved at each stage. Studies were synthesized through a narrative review with full tabulation of the results of all included studies.   Robustness and uncertainty were evaluated using deterministic and probabilistic sensitivity analyses. RESULTS: RDN substantially reduced event probabilities.  Median survival increased for RDN compared to standard of care. RDN was cost-effective in comparison to standard of care in the reviewed published estimates of cost-effectiveness. These estimates can not be directly extrapolated to other settings due to potential variations in cost structures and different  treatment patterns among countries that may influence final results. Findings were relatively insensitive to variations in input parameters except for systolic blood pressure reduction, baseline systolic blood pressure, and effect duration. Renal denervation gave improved outcomes. CONCLUSIONS: RDN appears to be a clinically effective and cost-effective intervention in resistant hypertensive patients compared with standard of care. Literature review suggests that RDN, over a wide range of assumptions, is a cost-effective strategy for resistant hypertension that might result in lower cardiovascular morbidity and mortality. Uncertainties remain and further research in Kazakhstan is required to provide detailed data on patient QoL and cost effectiveness in the local setting.