Background and Objective: Alcohol consumption is responsible of the global burden of disease and contributes to a number of diseases and deaths each year globally. Among the established adverse health effects of alcohol consumption there is hypertension. Our purpose is to assess the association between chronic alcohol exposure and incidence and mortality from hypertension in cohort studies, by carrying out a dose-response meta-analysis. Methods: After performing a comprehensive literature search in PubMed and Embase through December 2, 2022, we retrieved 17 eligible cohort studies. We assessed the risk of bias of the studies and we used a restricted cubic spline model with three knots to model the prospective association between alcohol consumption and incidence of hypertension. Results: We observed a linear positive association between alcohol exposure and hypertension risk, which in sex-specific analysis was confirmed only in males. Conversely, in females an increased risk emerged only above 12 g of daily alcohol intake. Conclusions: Our results support a causal association between alcohol intake and the risk of hypertension, thus adding to the evidence recommending to decrease any amount of alcohol consumption in order to improve cardiovascular health. While any amount of alcohol use appeared to be detrimental in males, this may not be the case for females in case of low amounts of consumption.