OBJECTIVES: Resistant hypertension is a difficult condition to treat. More than 5,000 patients with resistant hypertension have undergone surgery catheter based renal denervation (RDN) with good results. The primary objective of this study was to estimate the cost-effectiveness of catheter based renal denervation (RDN) for resistant arterial hypertension compared with standard of care (SC) in Colombia. METHODS: Using a previously validated excel-based Markov model, we projected the lifetime effect of RDN or standard of care in direct medical costs and outcomes. The model considered 6 health states: stroke, myocardial infarction, heart failure, end-stage renal disease, angina and death; The relative risk associated with RDN compared to SC for stroke (0.77), Myocardial infarction (0.74-0.90), Heart Failure (0.73) and end-stage renal disease (0.87) were extracted from the literature and converted into transition probabilities. Costs for drugs, procedures and other health care resources were obtained from local sources, and private and official databases. Life expectancy data was imputed from the WHO’s life tables and the utilities for each health state were derived from the literature. The analysis was performed using the payer perspective and used an annual discount for cost and outcomes of 3%. RESULTS: In our simulation, subjects undergoing RDN achieved higher QALY’s (10.27 vs. 9.72) at a higher cost during their lifetime (COP$91.406.781 vs. COP$80.799.285). The main drivers for these differences were the reduction in complications in the  group of subject treated with RDN and the costs of treatment. These differences yielded and ICER of COP$19.301.843. CONCLUSIONS: Catheter based RDN compared with standard care appears to be a favorable strategy for resistant arterial hypertension in Colombia, resulting in lower cardiovascular morbidity and mortality and decreased renal complications.