Hypertension per se is not a disease but is definitely a risk factor of immense importance. Of late, the prevalence of hypertension in the young adult population in India is rising—more in men than women. Over 11% of the population aged 15–49 years in India is hypertensive. Young-onset hypertension (YOH) is defined as the onset of hypertension in individuals aged < 40 years. This number is escalating with lifestyle behaviours and the lowering of international hypertension diagnostic thresholds to SBP/DBP of 130/80 mm Hg. The prevalence of YOH is relatively higher in urban than in rural areas at the national level—but the rural–urban difference is small—implying that the hypertension epidemic is spreading fast in the rural population. An increasing number of young persons in India are at risk of developing hypertension due to a multiplicity of factors—rising affluence, urbanization, sedentary lifestyle, changing dietary habits, obesity prevalence, social stress, and possibly genetic factors—thus increasing the risk of cardiovascular events in middle age, resulting in impaired health and productivity. Among young adults, diastolic hypertension is reported to be more common (62%) than isolated systolic hypertension (28%). The end result is that this young population has a higher prevalence of hypertension associated with cardiac, renal, neurological, ophthalmic, and other complications. As a result, it contributes to an earlier onset of coronary heart disease, heart failure, chronic kidney disease, ocular hemorrhages, stroke, transient ischemic attacks, cognitive decline, and dementia.