ABSTRACT The study aimed to assess the prevalence of uncontrolled hypertension and associated factors among hypertensive patients on follow up in selected public hospitals. This cross-sectional study was conducted from February to March 15, 2022. The study participants were selected by systematic random sampling technique, and data were collected using a structured and pretested questionnaire and a patient chart review. The collected data were analyzed using SPSS version 25. Binary and multivariate logistic regression was used. A total of 336 adult hypertensive patients were selected from this 94.6% of them were participated in the study, and the mean age of participants was 59.71 ±7.552 years. The prevalence of uncontrolled hypertension was 48.1%. Advanced age, comorbidity, non-adherence to low-salt diets, Alcohol abuse, weight management activities and comorbidities such as diabetes and cardiovascular diseases were significantly associated with uncontrolled hypertension in the multiple logistic regression analysis. Hypertensive patients who were obese or high body mass index was 4.7 times more likely to have uncontrolled hypertension, and patients who were not adherent to Alcohol abstinence 2.5 times more likely to have uncontrolled hypertension. The prevalence of uncontrolled hypertension in this study was very high, and non-adherence to a low-salt diet, physical exercise, and weight management were significantly associated with uncontrolled hypertension. Therefore, The Federal Ministry of Health should develop national strategic guidelines and public health initiatives focusing on education, lifestyle modification. Keywords: Uncontrolled hypertension, prevalence, associated factors, Adult patients