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To determine the prevalence and demographics of elevated blood pressure (BP) in emergency department (ED) patients.Retrospective study at an academic ED. ED patients with any systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg over a 1-year period were included. Data pertaining to frequency of elevated BP across different ethnic categories, age groups, days of the week, shifts, and gender were collected.A total of 44435 patient records were accessed. Overall 47.6% (95% CI, 47.2%-48.1%) of patients had elevated BP (SBP ≥140 mm Hg or DBP ≥90 mm Hg). Fifty three percent (95% CI, 52%-54%) were women. Among patients with elevated BP, 18% (95% CI, 17.8%-18.9%) had severe BP elevation (SBP ≥180 or DBP ≥110). Overall, patients >45 years old were more likely to have elevated BP in ED. Across all ethnic groups, BP increased with age. Significant differences were noted in the prevalence of elevated BP between whites (52%), and other ethnic groups (African Americans [45%] and Hispanics [31%]) (P < .01). Overall, 64% (95% CI, 63.3%-64.6%) of patients with elevated BP were discharged from the ED. Forty four percent (95% CI, 42.4%-45.5%) of patients with severe BP elevation were also discharged from the ED.This study provides knowledge of distribution of elevated BP among different age, gender and ethnic groups in the ED which can be used to develop specific interventions to improve recognition, prevention, detection, and treatment of hypertension.