Objective: This systematic review and meta-analysis aimed to (I) evaluate the evidence on the effects of high-intensity interval training (HIIT) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive patients; (II) determine whether HIIT impacts SBP and DBP differently; and (III) assess the clinical relevance of these effects. Methods: A comprehensive search was conducted across multiple electronic databases, resulting in the inclusion of seven randomized clinical trials in the meta-analysis. The outcomes were analyzed using random-effects models to compute mean differences (MD) and standardized mean differences (SMD) for SBP and DBP. Results: A small reduction in SBP was observed with HIIT interventions (MD -3.00; 95% CI -4.61 to -1.39; p < 0.0001; SMD -0.28; 95% CI -0.42 to -0.13; p = 0.0003). However, no statistically significant reductions were detected for DBP (MD -0.70; 95% CI -1.80 to 0.39; p = 0.21; SMD -0.07; 95% CI -0.22 to 0.08; p = 0.35). Despite demonstrating statistical significance for SBP, the effects did not reach clinical relevance. Conclusions: HIIT interventions yield small reductions in SBP, with minimal impact on DBP. These findings suggest limited clinical relevance in the management of hypertension. Further randomized controlled trials are necessary to standardize HIIT protocols, with specific emphasis on intensity control and manipulation, to better understand their potential role in hypertensive populations. C1 [Romero-Vera, Luis] Univ Mayor, Escuela Kinesiol, Fac Med & Ciencias Salud, Fisiol Clin Ejercicio, Santiago 8580745, Chile. [Ulloa-Diaz, David] Univ Catolica Santisima Concepcion, Dept Sports Sci & Phys Conditioning, Concepcion 4030000, Chile. [Araya-Sierralta, Sergio] Univ Atacama, Fac Humanidades & Educ, Copiapo 1531772, Chile. [Guede-Rojas, Francisco] Univ Andres Bello, Exercise & Rehabil Sci Inst, Fac Rehabil Sci, Sch Phys Therapy, Santiago 7591538, Chile. [Andrades-Ramirez, Oscar] Univ Amer, Escuela Ciencias Act Fis, Fac Salud & Ciencias Sociales, Concepcion 4030000, Chile. [Carvajal-Parodi, Claudio] Univ San Sebastian, Escuela Kinesiol, Fac Odontol & Ciencias Rehabil, Concepcion 4081339, Chile. [Munoz-Bustos, Gustavo] Univ Santa Tomas, Escuela Nutr & Dietet, Fac Salud, Iquique 1100000, Chile. [Martinez-Garcia, Dario] Univ Granada, Fac Sport Sci, Dept Phys Educ & Sport, Granada 18011, Spain. C3 Universidad Mayor; Universidad Catolica de la Santisima Concepcion; Universidad de Atacama; Universidad Andres Bello; Universidad de Las Americas - Chile; Universidad San Sebastian; University of Granada