Abstract: This paper systematically sorts out the historical evolution and modern research progress of moxibustion in the treatment of essential hypertension. It analyzes the development of moxibustion in the treatment of hypertension from early experience to the formation of theory, from clinical exploration, initial systematization of clinical research to the current development results, reflecting the scientific and innovative transformation of moxibustion in the treatment of essential hypertension. It reveals that moxibustion can achieve antihypertensive effects through multiple pathways, including neuron-body fluid regulation, renin-angiotensin-aldosterone system regulation, cell signaling pathway regulation, vascular homeostasis, and immune system function regulation, emphasizing its internal consistency from macroscopic syndrome differentiation to microscopic mechanism. Through systematic integration, it can not only highlight the unique advantages of moxibustion in "multi-dimensional adjustment", but also provide a new perspective for breaking through the single-target limitation of current antihypertensive drugs.