Background: In spite of the advances in hypertension prevention and treatment, there is a high percentage of people with elevated or uncontrolled blood pressure. New patient-centered strategies are needed to support people managing their condition. A complementary behavioral treatment, the mindfulness-based stress reduction (MBSR) program, needs to be evaluated for its potential to reduce blood pressure. Aims: To examine the literature on MBSR program effectiveness for blood pressure in adults with hypertension or elevated blood pressure. Methods: A systematic literature review of randomized control trials reporting the effectiveness of the MBSR program on systolic and diastolic blood pressure in people with hypertension or elevated blood pressure, published between 2012 and 2017 was conducted. Five databases were searched (PubMed, EMBASE, Web of Science, PsycINFO, and Cochrane Library). Data extraction and risk-of-bias assessment were performed. Results: A total of five articles were included in the review. Most studies found a reduction in systolic and diastolic blood pressure between the intervention and control groups; however, this reduction was only observed in clinical blood pressure (in office settings) and not in ambulatory blood pressure (in out-of-office settings) measurements. Analysis within intervention groups suggests that MBSR program reduces clinical blood pressure measurements. Even though these reductions in blood pressure may be of clinical relevance, the findings should be interpreted with caution in view of the lack of studies and study limitations. Linking evidence to action: The MBSR program is a promising behavioral complementary therapy to help people with hypertension lower their blood pressure through modifications in their lifestyle. More research is needed not only to identify the effectiveness of the MBSR program on blood pressure, but also to explore the mechanisms by which the program influences blood pressure.