Objective: To summarize the clinical features,causes and outcomes of 6 cases of hypertention in children with initial symptoms for acute heart failure.Methods: Data of these 6 children admitted into Shandong Provincial Hospital from January 2010 to May 2015 were analized retrospectively.Results: Four patients were male,two patients were female.The onset age ranged from 5 months to 13 years(mean 3.7 years).The initial clinical manifestations of these 6 patients were heart enlargement and heart failure.4 cases were diagnosed of dilated cardiomyopathy,1 was diagnosed of fulminant myocarditis,and another one was diagnosed of hypertrophic cardiomyopathy.The primary diseases were renal artery stenosis which secondary to retroperitoneal space occupying in 2 cases,right inferior renal artery embolization in 1 case,renal parenchyma disease in 1 case and postoperative ganglion cell tumor with renal artery stenosis in 1 case.Conclusion: hypertention in children is ignoered easily in clinic and is misdiagnosed as heart failure when developed to hypertensive crisis.It is key to monitor blood pressure.