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The aim of this trial was to evaluate the feasibility and effect of home-based transcutaneous electrical acupoint stimulation (TEAS) in patients with hypertension. In this randomized pilot trial, patients with hypertension were randomly assigned to the TEAS group or the usual care group. Participants in the usual care group were instructed to continue taking their antihypertensive drugs and received education on lifestyle modifications. In addition, participants in the TEAS group received 4 weekly sessions of noninvasive acupoint stimulation for 12 weeks at home. The primary outcome was the change in office systolic blood pressure at week 12 from baseline. Withdrawal from the study and adverse events associated with TEAS were also recorded. Sixty patients were randomized, with 30 patients in the TEAS group, of whom 1 was lost at week 36, and 30 patients in the usual care group, of whom 3 were lost by week 12. The reduction in systolic blood pressure at week 12 was greater in the TEAS group (−8.53 mm Hg; 95% CI [−13.37, −3.70 mm Hg]) than in the usual care group (−1.70 mm Hg; 95% CI [−4.29, −0.89 mm Hg]), with a between-group difference of −6.83 mm Hg (95% CI, [−12.23, −1.43 mm Hg]; P = 0.014). No TEAS-related adverse events occurred. In conclusion, home-based TEAS added to usual care for patients with hypertension was acceptable and safe and may be a potential treatment option. A larger randomized controlled trial of this intervention is warranted., Home-based transcutaneous electrical acupoint stimulation added to usual care for patients with hypertension was acceptable, safe and may be a potential treatment option. TEAS, transcutaneous electrical acupoint stimulation; SBP, systolic blood pressure.