CYP11B2 encodes aldosterone synthase, a mitochondrial cytochrome P450 monooxygenase that catalyzes the three sequential oxidative reactions converting 11-deoxycorticosterone to aldosterone 12. The enzyme catalyzes 11-beta hydroxylation followed by two successive C18 oxidations to generate 18-hydroxy and 18-oxo intermediates, ultimately producing aldosterone 13. CYP11B2 also produces 18-hydroxycortisol and 18-oxocortisol from cortisol oxidation, which are significantly elevated in primary aldosteronism, the most common form of secondary hypertension 45. The enzyme requires molecular oxygen and electrons provided by NADPH through the mitochondrial transfer system comprising FDXR and FDX1/FDX2 proteins 16. Aldosterone, the primary mineralocorticoid product, regulates salt and water homeostasis, blood pressure, and arterial function 1. CYP11B2 expression is regulated by angiotensin II and potassium levels in the zona glomerulosa, with epigenetic DNA methylation dynamically controlling expression 7. Age-related increases in aldosterone-producing cell clusters and autonomous aldosteronism correlate with cardiovascular risk 8. Mutations in CYP11B2 cause familial hyperaldosteronism type I when creating hybrid ACTH-regulated CYP11B1/CYP11B2 genes 9. Selective CYP11B2 inhibitors represent potential therapeutics for resistant hypertension 10.