Autonomous aldosterone overproduction represents the underlying condition of 5-10% of patients with arterial hypertension and carries a significant burden of mortality and morbidity. The diagnostic algorithm for primary aldosteronism (PA) is sequentially based on hormonal tests (screening and confirmation tests), followed by lateralization studies (adrenal CT scanning and adrenal venous sampling) to distinguish between unilateral and bilateral disease. Despite the recommendations of the Endocrine Society guideline, PA is largely underdiagnosed and undertreated with high betweencentre heterogeneity. Experts from the European Society of Hypertension have critically reviewed the available literature and prepared a consensus document comprising two articles to summarize current knowledge on the epidemiology, diagnosis, treatment and complications of PA. This position paper also discusses the next challenges and future directions of research in this field.