Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are the first-line drugs for the treatment of hypertension, and are taken by a significant proportion of hypertensive patients undergoing elective surgery. However, there is a great controversy over whether such antihypertensive drugs should be continued before surgery, which may be attributed to the uncertainty about the risks and benefits of continuing such drugs. This article systematically reviews the effects of continuing these drugs on perioperative complications such as intraoperative hypotension, postoperative organ damage and postoperative mortality, in order to provide a reference for anesthesiologists in clinical practice.