To evaluate the alterations in blood pressure (BP) and heart rate (HR) among hypertensive and normotensive patients receiving dental local anesthesia using 2% lidocaine with epinephrine. This prospective observational study was carried out at the College of Dentistry, Jazan, KSA. A total of 40 adult patients were included in the study. They were divided into two groups (n=20). Group “A” included normotensive patients and group “B” included controlled hypertensive patients. The BP and HR were measured by a sphygmomanometer and pulse oximeter in three different temporal locations: on arrival to the waiting room, and in clinic before and after administration of local anesthesia. The mean values of the measurements in the three locations; the waiting area, clinic before and after the administration of DLA, were noted. The only significant alterations were found in the Systolic Blood Pressure (SBP) of both hypertensive and normotensive patients before the administration of DLA and in the HR of hypertensive patients again only before the administration of DLA. Endogenous catecholamines are more significant in causing hemodynamic disturbances in dental patients. Hypertensive patients seem to be more vulnerable to these disturbances.