Abstract: Elevated blood pressure following acute high-altitude exposure is a common physiological stress response. However, excessive elevation or improper management may precipitate hypertensive emergencies and increase the risk of cardiovascular and cerebrovascular events. Currently, there is a lack of systematic clinical guidance for blood pressure management in this specific context. To address this gap, the Hypertension Committee of the Chinese Medical Doctor Association convened a multidisciplinary panel of experts to develop this consensus, based on available evidence and clinical practice. This consensus systematically elaborates on the characteristics, core pathophysiological mechanisms, and association with acute high-altitude illness of blood pressure elevation after acute high-altitude exposure. It proposes a classification system for the severity of blood pressure elevation and a framework for cardiovascular risk assessment prior to high-altitude exposure. The document focuses on discussing the efficacy, safety, and evidence for antihypertensive medications with different mechanisms of action in high-altitude environments. Furthermore, it establishes a clinical management pathway encompassing blood pressure monitoring, high-altitude pre-adaptation, intervention for elevated blood pressure, and management of high-altitude-related hypertensive emergencies. This consensus aims to provide standardized and practical decision-making references for clinicians, thereby improving the comprehensive management of blood pressure elevation after acute high-altitude exposure.