Summary: Atherosclerotic renvascular disease (ARVD) is the most common type of renal artery stenosis asscoiated with high CV risk, renal event and increased overall mortality. The prevalence of ARVD in patients >65 years accounts for 6.8% of and among hypertensives is approx. 1% in subject with mild hypertenson and 14–24% in those with severe and resistant hypertension. This article summarizes current knowledge in epidemiology, diagnostic assessment and treatment of ARVD to support general practitioners in decision making and everyday management of patients with this common clinical condition.