The objective was to evaluate both the effectiveness and safety of urapidil (Ebrantil) in management of hypertensive emergencies in patients with acute coronary syndrome at the hospital stage and its comparison with other antihypertensive drugs. Systolic, diastolic pressure, and heart rate in 33 patients who were treated with urapidil at different dosage regimen (bolus from 12.5 to 50 mg) and 33 patients treated with other hypertensive drugs. The groups were selected as case — control and compared by the main clinical values. During the hospital treatment the clinical outcomes, rate and effectiveness in achieving target blood pressure were assessed. Urapidil (Ebrantil) use is more effective and safe in management of HE complicated with acute coronary syndome compared with other antihypertensive drugs.