Background: Hypertension (HTN) is an important health problem with great complications that can be prevented through proper management which depends mainly on patient compliance. Method: A cross-sectional study was conducted on attendants of the outpatient's clinic of Mansoura International Hospital (MIH) for HTN management during the period from January 2014 to June 2015. Results: The study included 350 patients; 170 (48.6%) of them were compliant with the medication regimen and 141 (59.7%) compliant to lifestyle modification. Compliance to medication regimen was mainly affected by gender, residence, work status and educational level, internal factors (personal factors), health care provider and cues to action. While gender, the perception of a barrier to compliance and internal factors (personal factors) were the predictors' for compliance to lifestyle modification. A proved relationship between compliance with medical regimen and lowering blood pressure level of the participants and also their BMI was detected. Conclusion: as compliance with medical regimen affect managing hypertension; so measures to increase patient's awareness about nature of HTN and its complication providing them with clear and direct messages. Continuous follow-up for the non-compliant patients to improve their behavior, involve them in the drug choice or decisions about treatment strategies. Incorporate family members to ensure medication compliance.