<p>The consequences of uncontrolled hypertension, often referred to as the "silent killer," encompass end-organ damage, leading to conditions, such as heart failure, myocardial infarction (heart attack), renal failure, and stroke. The recommended approach for managing high blood pressure involves both pharmacological and behavioral therapies. Existing evidence suggests that individuals with cardio-metabolic diseases may exhibit a deficiency in Coenzyme CoQ10 (CoQ10), potentially contributing to oxidative stress and inflammation associated with hypertension. Various mechanisms, including an increase in the dietary intake of antioxidant elements, have been postulated to underlie this phenomenon. Because of its anti-oxidative qualities, anti-inflammatory effects, impact on endothelial nitric oxide synthase, improvement of endothelial function, modulation of vascular smooth muscle activity, and reduction of arterial stiffness, CoQ10 has been suggested as a possible alternative therapy for hypertension and related complications. Clinical trials have produced findings that suggest CoQ10 supplementation may lower both systolic and diastolic blood pressure in individuals diagnosed with essential hypertension, frequently as a component of adjunctive therapy. Nonetheless, a thorough comprehension of the mechanisms that determine the effects of CoQ10 on blood pressure and its related complications continues to be elusive. This narrative review investigates the mechanistic effects of CoQ10 on hypertension and its accompanying consequences, with an emphasis on its pharmacological impact on inflammation and oxidative-related pathways. We have conducted an exhaustive literature search, identifying several studies that assess the safety and effectiveness of CoQ10 supplementation in hypertensive patients.</p>