The incidence of cerebrovascular events and peripheral vascular disease is higher in dialysis patients compared to the general population. Although normotensive dialysis patients have an elevated risk of stroke, hypertension remains an important risk factor for symptomatic cerebrovascular accidents. The risk of stroke increases in a linear fashion with blood pressure (BP) level. Furthermore, hypertension is also an important risk factor for silent cerebral infarction in dialysis patients. With regard to peripheral vascular disease, the association with hypertension is less clear. The spectrum of cerebrovascular accidents differs from the general population, as the relative incidence of cerebral hemorrhage to cerebral infarction is much higher. The prognosis of cerebral hemorrhage is poor and depends on the size and location of the hemorrhage. In order to prevent noncardiac complications, strict control of hypertension is of major importance in dialysis patients.