Background: Noncompliance to treatment in chronic diseases such as hypertension is a very common phenomenon, owing to its chronic nature, lack of obvious symptoms, affordability, doctor-patient relationship, unawareness of complication, and forgetfulness. This noncompliance negatively affects disease course and increases risk of morbidity and mortality. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1999, through March 2017. The following search terms were used: drug compliance, hypertension medication compliance, antihypertensive drug compliance, factors affecting compliance, medication compliance. Aim: Our aim in carrying out this study was to understand the status of medication compliance among hypertensive patients, studying the factors that affect it, and exploring ways to improve compliance.Conclusion: We have noticed in the review that there is direct correlation between noncompliance and lack of proper doctor-patient relationship, patient education, and patients' belief about disease and treatment. Improvement on such factor can benefit the patients in great amount regarding blood pressure control and in preventing morbidity and mortality. More studies to analyze the lack of compliance must take place in Saudi Arabia, and stricter guidelines of doctor-patient- relationship must be reinforced.