Hypertensive emergencies, including hypertensive encephalopathy represents an acute threat to vital organ functions and call for urgent treatment. The intravenous medications currently available for the management of hypertensive emergencies, have significant potential for serious side effects and acute lowering of blood pressure has often been the cause of considerable morbidity and mortality. Nifedipine is known to be effective as an antihypertensive agent and it is widely used in hypertensive emergencies. We studied the efficacy and effective dose of nifedipine in 22 patients (9 females and 13 males; mean age 51) with hypertensive encephalopathy. Nifedipine (20 mg by oral drop) caused a significant fall in diastolic an systolic blood pressure in all patients from 236/121 to 172/96 mmHg after 30 minutes (P < 0.005, P < 0.001). Continuous therapy with nifedipine (2-5 mg every 2-3 hours, mean total dose 52 mg/24 h) gave successful control of blood pressure. These data prove that nifedipine can be used as the first-line drug for the treatment of hypertensive crises in patients with hypertensive encephalopathy.