Resistant hypertension poses a challenge in hypertension management, as some patients still experience difficulty in achieving stable blood pressure control despite undergoing standard treatment. Renal denervation (RDN) provides a device-based therapeutic alternative to pharmacotherapy by modulating renal sympathetic nerve activity. In recent years, with the advancement of ablation techniques such as radiofrequency and ultrasound, coupled with the accumulation of evidence from sham surgery control studies and long-term follow-up studies, the clinical value and application boundaries of RDN have garnered renewed attention. This article aims to summarize the progress of RDN in the treatment of refractory hypertension, highlighting its clinical research evidence, target population, renal safety, guideline positioning, and future research directions, with the hope of providing a reference for its standardized clinical application.