Resistant hypertension is failure to achieve goal blood pressure in spite of using a minimum of 3 antihypertensive drugs of different classes, one of which must be diuretic, at maximal tolerated doses. The prevalence of resistant hypertension ranges between 10-30% and is associated with higher risk of kidney and cardiovascular system damage. Treatment of resistant hypertension focuses on lifestyle modifications and pharmacological therapy. Device-based therapies are indicated in patients in whom pharmacological agents failed to control the blood pressure. Evidence suggests beneficial effects of renal sympathectomy on life expectancy and prevention of cardiovascular complications in patients with resistant hypertension. There are also reported effects of renal sypmathetic denervation in several conditions such as chronic kindey disease, type 2 diabetes mellitus, sleep apnea, arrhythmias, left ventricular hypertrophy, and heart failure. Studies showed that renal denervation reduces LV mass, improves diastolic function, and reduces the burden of atrial and ventricular arrhythmias. RDN also significantly improves arterial stiffness and central hemodynamics, which might have important prognostic implications in patients with resistant hypertension and high cardiovascular risk. Following RDN, the magnitude of albuminuria, as well as the prevalence of micro- and macroalbuminuria, decreased in treatment-resistant hypertensive patients. Chronic activation of the sympathetic nervous system has been associated with the components of metabolic syndrome, such as hyperinsulinemia, type 2 diabetes, and obesity. In patients who had renal denervation treatment, drops in fasting glucose, insulin level, and 2-hour glucose levels during an oral glucose tolerance test were observed.