Renal arterial stenosis (RAS) hypertension is one of the common types of secondary hypertension. The main clinical manifestations are increased levels of renin and aldosterone, abnormal renal function and refractory hypertension that is difficult to control by drugs. In this paper, a case with refractory hypertension due to atherosclerotic renal artery stenosis was reported and the relevant literature was reviewed. The patient was a middle-aged male who could not control his blood pressure within the ideal range despite oral administration of amlodipinebesylate, terazosinhydrochloride, irbesartan, carvedilol, metoprololsuccinate, diltiazium hydrochloride and other drugs, requiring continuous pumping of nitroglycerin to lower blood pressure. Furthermore, the examination of renal artery angiography revealed severe stenosis at the origin of the left renal artery. After stent implantation at the renal artery stenosis, blood pressure could be controlled to the standard by oral administration of terazosin hydrochloride, amlodipine besylate and diltiazem hydrochloride only. There are many reasons leading to secondary hypertension. This paper discusses the common causes of renal artery stenosis as a starting point, in order to deepen the understanding of secondary hypertension and reduce the occurrence of missed diagnosis or misdiagnosis.