Aliskiren is the only FDA approved direct renin inhibitor. It is generally accepted as an antihypertensive agent but it is mostly regarded as a third-line agent in the treatment of hypertension. It is relatively new and has potential to have immense benefits because it directly inhibits Renin so other members of the system are inhibited. In clinical practice, it is effective not only in normal hypertensive patients but also in hypertensive patients with special conditions like obesity, diabetes etc. It also has renal protective effects which are yet to be fully explored. It is effective in reducing the development of non-alcoholic steatohepatitis which is associated with metabolic syndrome. Even though, it is more expensive as compared to the other inhibitors of the RAS, more investigations need to be carried out because it shows much promise. Clinical trials of varying patients have shown that it could be effective in reducing oxidative stress in atrial fibrillation, reducing renovascular hypertension and preventing end organ damage. More longitudinal studies should be done in the future involving more patients to be able to fully discover its full role in clinical practice