INTRODUCTION Hypertension is a common medical problem mainly treated by effective antihypertensive drugs. Persistent hypertension can be difficult to manage and have detrimental effect on vital organs. Nephrectomy of poorly functioning kidneys may be indicated in a minority of such cases. PATIENTS AND METHODS We performed laparoscopic nephrectomy on 12 patients with refractory hypertension. RESULTS Eight had complete response, three had partial response and one had no response. CONCLUSIONS Laparoscopic nephrectomy has a role in carefully selected adult patients with refractory hypertension due to non-functioning kidney. Patients need to understand the surgical risks as well as the small risk of failure to treat hypertension.