Objective: Results from the prospective, randomized, sham-controlled SPYRAL HTN-ON MED trial to assess blood pressure (BP) reduction post-renal denervation (RDN) have been previously published. We wished to examine the impact of RDN on individual patterns of BP during the critical “morning surge” period, as inappropriately high sympathetic tone may lead to increased hypertensive cardiovascular risk, especially during the early morning surge period. Design and method: A total of 80 patients were randomized to RDN (N = 38) or sham control (N = 42) in the trial and BP was measured at baseline, 3 and 6 months. Hourly systolic (SBP) and diastolic BP (DBP) plots were created by plotting the mean BP measured with ambulatory BP monitoring at each hour across 24 hours. We calculated the slopes of hourly BP data separately for each subject during the morning hours (6–10AM) using linear regression models. Morning slopes were compared between baseline, 3 and 6 months within each treatment group using paired t-tests, and between RDN and control groups at each timepoint using unpaired t-tests. Results: Mean DBP morning slope at baseline, 3 and 6 months were 4.1, 2.8, and 1.1 mmHg/hour for the RDN group and 3.8, 4.5 and 3.6 mmHg/hour for the control group, respectively. DBP morning slopes were significantly lower for RDN vs. control groups at 6 months (1.1 vs. 3.6; p = 0.029). Within the RDN group, DBP morning slopes were significantly lower at 6 months compared to baseline (4.1 vs. 1.1; p = 0.006). Similar patterns were observed for mean SBP morning slope but did not reach statistical significance. Conclusions: DBP morning slope, an index of the sympathetically mediated morning BP surge, significantly decreased from baseline to 6 months in the RDN group indicating a drop in late morning BP relative to early morning/nocturnal BP. A similar decrease was not seen in the control group. Thus, RDN appears effective in attenuating the morning surge in DBP.