A review is presented of the potential ways in which insulin resistance and hypertension may be linked. Although controversy exists as to the role insulin resistance and hyperinsulinemia play in the pathogenesis of hypertension, data are presented from both obese and nonobese subjects that strongly suggests that selective insulin resistance and hypertension are directly related. Because insulin resistance may be both tissue and pathway specific, it is possible that the degree to which insulin resistance is tissue specific determines whether hypertension will develop in specific individuals or animals.