Hypertension affects vascular endothelium of retina, kidney, and heart. These are called as target organ damage (TOD). Hypertension causes endothelial damage by shear mechanical stress which leads to platelet aggregation and activation. This article is a review for prediction of TOD in hypertensives by cost effective routine indicators like platelet indices [platelet distribution width (PDW), mean platelet volume (MPV) and platelet count]. Hypertension mediated target organ damage like left ventricular hypertrophy, hypertensive retinopathy and nephropathy is associated with increased platelet indices like MPV, PDW, and PLT. The use of these cost-effective platelet indicators in newly diagnosed hypertensives may need further studies to have clinical implications.