Objective: To explore clinical characteristics and risk factors of adolescent patients with hypertension. Method: A total of 324 adolescent inpatients aged 14 to 24 years old from 2004 to 2011 were enrolled. The disease history, family history, height, weight, office blood pressure, 24-hour ambulatory blood pressure, echocardiography data, and related biochemical indexes were collected. Results: In general, secondary hypertension accounted for 27.78% (90/324) while essential hypertension accounted for 72.22% (234/324). There was 53.42% (125/234) essential hypertension patient suffered metabolic abnormality in which overweight (22.22%) and obesity (18.80%) took the majority. Male patients had more severe obesity and metabolism disorder. There was no significant difference of biochemical indexes and target organ damage between positive and negative family history groups (P < 0.05). Multiple linearregression analysis showed that 24 hours average pulse pressure was positively correlated with BMI(ß = 0.145, P = 0.045). The most common target organ damage took 17.48% was left ventricular hypertrophy. And left ventricular hypertrophy index was positively related to BMI and 24hSBP (ß = 0.302, P < 0.0001; ß = 0.371, P < 0.0001). In logistic regression, BMI was the main risk factors to left ventricular hypertrophy (OR: 1.111, 95%CI 1.027–1.203). Conclusion: Most of hypertensive adolescentscan not find apparent cause of secondary hypertension. Metabolic disorders such as overweight and obesity which closely related with blood pressure especially pulse pressure should beactivelycorrected, and the aggregation of cardiovascular risk factors and target organ damage should be controlled.