Background:  Funduscopy is utilized directly to detect vascular alterations in the eye. Arteriolar tightness is a distinctive feature of hypertensive retinopathy; this tightness can be diffuse or focal in nature. This happens when the blood pressure in the systemic circulation rises in order to maintain a consistent flow of blood through the process of autoregulation of the circulation in the retina. Aim and objectives: To evaluate peripapillary microvascular alterations in hypertensive cases, focusing on vascular density by utilizing OCT angiography. Patients and Methods: This research is a prospective comparative case control research at Benha University Hospital outpatient clinics between July 2022 and July 2023 on 60 subjects (120 eyes), who were divided into three groups and were examined for the peripapillary microvascular changes including vascular density using OCT angiography; Group A: twenty normal subjects, Group B: 20 subjects who had hypertension for more than ten years, and Group C: 20 subjects with hypertension for less than 10 years. Results: A significant variance was observed among participants under study regarding best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), superior temporal vascular density and no significant difference was found regarding peripapillary of vascular thickness. Conclusion:     Our results showed that there was significant change in peripapillary microvascular density in cases who had hypertension lasting more than ten years.