Blood pressure (BP) is the major risk factor for cardiovascular diseases and is one of the leading causes of death in the US. Dietary modification, the cornerstone of lifestyle interventions, is recommended for prevention and treatment of hypertension. Current clinical guidelines recommend reducing dietary sodium and increasing potassium intake as effective interventions for BP management. Recent evidence suggests that the dietary sodiumto- potassium ratio may be a stronger and a more reliable determinant of BP, as this ratio takes into account both sodium and potassium intake. Dietary recommendations to decrease sodium-to-potassium ratio by modest reduction in sodium and increase in potassium intake may be more effective for BP management than reducing dietary sodium alone. The objectives of the current review were to evaluate the evidence studying the relationship of dietary sodium, potassium and sodium-to-potassium ratio with changes in BP, and to assess whether dietary sodium-to-potassium ratio would be a more effective and practical dietary factor to consider for prevention and treatment of hypertension.