The role of high Blood Pressure levels on target organ damage and the protective effects of antihypertensive therapy have been extensively established in clinical practice [1]. Mortality from ischemic heart disease and stroke doubles every increment in 20 and 10 mmHg of systolic and diastolic blood pressure [1]. Nowadays, besides usual blood pressure other parameters contribute to TOD in hypertensive patients [2]. Blood pressure is a constant variable and it shows marked spontaneous oscillations over short-term (minutes to days) and long-term (month) periods [3]. Early reports from animal models of cardiovascular variability have clearly demonstrated the relationship between excessive fluctuation in blood pressure values and the development of target organ damage [4]. The initial hypothesis was further corroborated by clinical studies in hypertensive subjects showing that the assessment and quantification of Blood Pressure Variability (BPV) is of physio-pathological and prognostic importance [5]. In recent years, many preclinical and clinical studies have clearly identified the contribution of BPV to the cardiovascular complications associated with hypertension [6]. Moreover, preliminary data from retrospective analysis of clinical trials suggest that attenuation of BPV by antihypertensive agents contribute in the prevention of major cardiovascular events in hypertensive patients [7]. Considering the recent advances in the knowledge of the pathological role and clinical significance of BPV in cardiovascular diseases, the present case illustrates the Blood Pressure Variation in a routine OPD setting.