Introduction: High blood pressure is one of the comorbidities frequently associated with type 2 diabetes. However, its therapeutic management is often characterized by therapeutic inertia. This study aimed to assess the prevalence and factors associated with therapeutic inertia in the pharmacological management of high blood pressure in patients with type 2 diabetes. Methodology: This was a cross-sectional, descriptive, and analytical study conducted in Ouagadougou from January 1, 2022, to December 31, 2024. The analysis included the evaluation of the score, modalities, and factors associated with therapeutic inertia. Results: A total of 384 patients were included. The average age of the patients was 61.03 years, with a strong female predominance. The average duration of diabetes was 13.97 years and that of high blood pressure was 15.52 years. More than half of the patients (52.08%) experienced therapeutic inertia. The overall therapeutic inertia score was 61.41%. The only form of therapeutic inertia observed was the failure to intensify antihypertensive treatment. Non-compliance and discontinuation of antihypertensive treatment were the factors significantly associated with therapeutic inertia. Conclusion: The therapeutic management of high blood pressure is inadequate in patients with type 2 diabetes in Ouagadougou, as characterized by a high therapeutic inertia score. The only form of therapeutic inertia observed was the failure to intensify treatment, which was associated with non-compliance and discontinuation of antihypertensive treatment.