Abstract: Peroxisome proliferator-activated receptor γ coactivator (PGC)-1α, a member of the PGC-1 family, plays a pivotal role in regulating mitochondrial biogenesis and the expression of respiratory chain complex subunits. In recent years, growing evidence from domestic and international studies has revealed that PGC-1α influences blood pressure through multiple mechanisms, including the modulation of oxidative stress, inflammatory responses, and nitric oxide synthesis. Moreover, various pharmacological agents have been shown to exert antihypertensive effects via PGC-1α-mediated pathways, such as inhibition of cardiovascular remodeling, anti-inflammatory, and antioxidant actions. This review summarizes the molecular mechanisms by which PGC-1α participates in blood pressure regulation, discusses its potential as a therapeutic target, and explore the clinical translation prospects, in order to provide insights for mechanistic research and targeted interventions in hypertension and related cardiovascular diseases.