The objective of this study was to identify and compare clinical and claims-based pediatric hypertensive patients in the FDA Sentinel System. FDA sought to determine the feasibility of using blood pressure values for identifying hypertension in the pediatric population. Pediatric hypertension in claims-based data sources is under-captured but also serves as a marker for greater disease severity. Investigators should understand coding practices when using real world data (RWD) sources for identification of pediatric hypertension in future work. This study compared and examined overlap between the two methods for identification of pediatric hypertensive patients (claims-based and clinical electronic health record [EHR]-based) over a 36-month period in the Sentinel System. Furthermore, it provided guidance for the use of RWD in future pediatric hypertension studies.