Objective: To gather and synthesize current evidence that evaluates Pharmaceutical Services in hypertension, from an economic point of view. Methods: A systematic review of articles published from 2009 to September 2020 in PubMed, Scopus, Lilacs and Cochrane was carried out, following PRISMA guideline. Two reviewers screened and selected independently of the studies, extracted the data and assessed the risk of bias. Results: 2,223 articles excluding duplicates were found in the databases. After analyzing the inclusion and exclusion criteria, 12 studies were included, 8 were experimental and 4 were observational. The PS was performed in community pharmacies, outpatient clinics and hospitals, with interventions performed only by pharmacists or in collaboration with other professionals. Most of the interventions were cost-effective, improving clinical parameters and improving the quality of life. Only one intervention did not show significant results in relation to usual care. Conclusion: PS have been associated with positive economic impacts and interventions have significantly reduced direct medical costs. However, there is a need to develop more robust research, such as randomized and controlled studies, in order to allow a more assertive assessment regarding the cost-effectiveness of pharmaceutical services