The circadian rhythm is an endogenous biological oscillation with a 24-hour period. Under normal physiological conditions, the circadian rhythm of blood pressure exhibits a diurnal variation characterized by a two-peak-one-trough pattern, with higher levels during the day and lower levels at night. Extensive studies have demonstrated that the circadian regulation of blood pressure depends on the precise integrative functions of the cardiovascular centers. The brainstem and hypothalamus modulate the dynamic balance between the sympathetic and parasympathetic activities via neurotransmitters, endocrine signals, and other pathways, thereby maintaining physiological fluctuations of blood pressure. Under pathological conditions, dysregulation of cardiovascular centers can lead to abnormal circadian rhythm of blood pressure, which is closely associated with cardiovascular diseases such as hypertension. Therefore, this review systematically examines the role and molecular mechanisms of cardiovascular center in regulating blood pressure circadian rhythms, providing a theoretical basis for revealing the pathogenesis of abnormal blood pressure rhythms and developing targeted therapies.