Obstructive sleep apnea-induced hypertension appears to constitute a distinct pathophysiologic entity. Various neurohormonal and inflammatory mediators and hypoxia-induced injury link the two conditions. Obstructive sleep apnea-induced hypertension appears to be reversible in its early phases, but becomes a permanent condition with irreparable vascular changes in later stages. Hence, defining obstructive sleep apnea-induced hypertension and elucidating its role in cardiovascular disease will facilitate appropriate prevention and intervention. This review will clarify the unique set of features of hypertension associated with obstructive sleep apnea and examine the mechanisms that contribute to its cardiovascular consequences.