Background-Oxidative stress seems to be present in all forms of hypertension. Thus, we tested the hypothesis that high intraluminal pressure (P i ) itself, by activating vascular oxidases, elicits increased superoxide (O 2 ·Ϫ ) production interfering with flow-induced dilation. Methods and Results-Isolated, cannulated rat femoral arterial branches were exposed in vitro (for 30 minutes) to normal P i (80 mm Hg) or high P i (160 mm Hg). High P i significantly increased vascular O 2 ·Ϫ production (as measured by lucigenin chemiluminescence and ethidium bromide fluorescence) and impaired endothelium-dependent dilations to flow; these effects could be reversed by superoxide dismutase. Administration of the NAD(P)H oxidase inhibitor diphenyleneiodonium, apocynin, the protein kinase C (PKC) inhibitor chelerythrine or staurosporin or the removal of extracellular Ca 2ϩ during high P i treatment prevented the increases in O 2 ·Ϫ production, whereas administration of losartan or captopril had no effect. High P i resulted in significant increases in intracellular Ca 2ϩ ([Ca 2ϩ ] i ) in the vascular wall (fura 2 fluorescence) and phosphorylation of PKC␣ (Western blotting). The PKC activator phorbol myristate acetate significantly increased vascular O 2 ·Ϫ production, which was inhibited by superoxide dismutase, diphenyleneiodonium, chelerythrine, or removal of extracellular Ca 2ϩ . Both high P i and phorbol myristate acetate increased the phosphorylation of the NAD(P)H oxidase subunit p47phox . Conclusion-High P i itself elicits arterial O 2 ·Ϫ production, most likely by PKC-dependent activation of NAD(P)H oxidase, thus providing a potential explanation for the presence of oxidative stress and endothelial dysfunction in various forms of hypertension and the vasculoprotective effect of antihypertensive agents of different mechanisms of action.