We report a case of severe hypertension following stellate ganglion block. A 61-year old woman received the left stellate ganglion block with 5 ml of 1% mepivacaine for her left facial palsy. Before the stellate ganglion block, blood pressure was 120/68 mmHg and heart rate was 62 b.p.m. Seven minutes after the left stellate ganglion block, blood pressure increased to 230/140 mmHg, but heart rate was unchanged. Systolic blood pressure remained above 190 mmHg for 60 minutes following the stellate ganglion block. We suggest that the extreme increase in blood pressure was due to the vagal nerve block associated with the left stellate ganglion block.