Abstract: Exercise intervention is an important non-pharmacological strategy in the management of hypertension. Although it effectively improves blood pressure control, it may also trigger cardiovascular events, particularly in patients with uncontrolled hypertension who are at higher risk. Therefore, systematic and scientifically grounded exercise risk assessment is a fundamental prerequisite for ensuring the safety and effectiveness of exercise participation.Based on the latest recommendations of the Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 revised edition), this paper systematically reviews the current status of localized application, core tools, and stratification criteria for exercise risk assessment in Chinese patients with hypertension, and proposes a population-specific assessment framework tailored to the Chinese population. It further focuses on the assessment strategies for patients with uncomplicated hypertension and those with comorbid conditions, and integrates emerging technologies such as artificial intelligence–assisted evaluation and wearable device monitoring.In addition, this review identifies key limitations in the current assessment system, including the lack of standardized criteria and insufficient dynamic monitoring. Practical clinical tools and solutions are provided to facilitate implementation. This work aims to promote the precise integration of exercise risk assessment with individualized exercise prescription, thereby providing a reference for clinical practice in China.