Elevated blood pressure is a major modifiable risk factor for cardiovascular disease and premature mortality worldwide, affecting an estimated 1.3 billion adults. Most patients achieve adequate blood pressure control with two or three antihypertensive drugs. Up to 20% of hypertension cases remain uncontrolled despite recommended combination therapy. After pseudo-resistance is excluded, these patients are classified as having true resistant hypertension. Resistant hypertension is a phenotype associated with increased cardiovascular risk. In these patients, the prevalence of secondary hypertension is higher. The article is devoted to the inhibition of aldosterone synthase in resistant hypertension and its promises and unknown aspects.