Objective: To describe clinical pharmacy services provided in a rural North Carolina primary care clinic and assess the impact of these services on systolic and diastolic blood pressures in patients with uncontrolled hypertension. Methods: This single-center, retrospective study evaluated change in systolic and diastolic blood pressures from baseline, percentage of patients with blood pressure reductions, percentage at The Eight Joint National Committee (JNC 8) goal blood pressure, percentage at care gap closure defined as obtaining a blood pressure <140/90 mm Hg, and time to reach care gap closure. Results: The mean change in systolic blood pressure was −20.1 mm Hg (14.716-25.418, P < .0001) and the mean change in diastolic blood pressure was −8.8 mm Hg (5.449-12.117, P < .0001). Eighty percent of patients experienced blood pressure reductions from baseline, 51% met their respective JNC 8 goal blood pressure, and 48% met care gap closure. The average time to reach care gap closure was 23 weeks. Conclusion: When embedded within a primary care clinic in a rural setting, a pharmacist-managed hypertension clinic significantly improved both systolic and diastolic blood pressures of patients with uncontrolled hypertension.