Findings demonstrate that a steady increase has occurred in hypertensive crisis hospitalizations, slightly more among men than women, with a simultaneous increment noted in the burden of cardiovascular conditions. These trends were revealed despite contemporaneous improvements in hypertension prevention and control nationwide.

• Researchers used data from the National Inpatient Sample to analyze gender‐pooled and gender‐specific temporal trends in hypertensive crisis hospitalization and case fatality rates over serial time periods: years 2002 to 2006, 2007 to 2011, and 2012 to 2014.

• Hypertensive crisis hospitalizations and in‐hospital deaths, during the entire study period (years 2002–2014), were estimated to be 918,392±9,331 and 4,377±157, respectively.

• Of all hospitalizations during the entire study period, 0.23%±0.002% were attributable to hypertensive crisis (0.24%±0.002% for men and 0.22%±0.002% for women).

• Multivariable analyses adjusting for age, race or ethnicity, and cardiovascular conditions showed an annual increase in the odds of experiencing a hospitalization mainly for hypertensive crisis for both men (odds ratio [OR], 1.083 per year) and women (OR, 1.07 per year) with a higher rate of increase noted in men than women.

• For death during hypertensive crisis hospitalization, the estimated multivariable‐adjusted odds reduced annually and similarly for men (OR, 0.89 per year) and for women (0.92 per year).