The development of obesity, as well as resultant type 2 diabetes, hypertension and cardiovascular disease, is causing concern in South Africa. Following the discovery of leptin in 1994, hopes were raised that the manipulation of the leptin axis might yield successful therapy for obesity. Although hope still remains, the role of leptin is more complex than was first envisaged. Strong evidence indicates that there is an important role for leptin in obesityrelated hypertension, although the net effects of hyperleptinaemia on cardiovascular pathophysiology remain complex and are not clearly understood. Therefore, the cardiovascular side-effects of leptin as a possible antiobesity drug deserve greater attention. ; http://www.jemdsa.co.za/index.php/JEMDSA/article/view/319/418