Background: Hypertension ranks first among the non-communicable diseases in Nigeria and globally. Interventions like lifestyle modifications, with its advantages, are often overlooked. Awareness and practice of these measures will aid in blood pressure control. Aim: To assess the level of awareness and practice of lifestyle modification among hypertensive adults in a semi-urban community of Olokoro in Umuahia South local government area of Abia state, Nigeria. Methods: A crosssectional study involving adult hypertensive patients who presented during a medical screening exercise. Structured pre-tested researcher administered questionnaire was used for data collection. Results: A total of 101 individuals were recruited; 58 (57.4%) males and 43 (42.6%) females. Mean age was 56.7±12 years with a range of 27 to 84 years. Mean systolic and diastolic BP were 143±17mmHg and 80±12mmHg respectively. Up to 87.1% were unaware that regular exercise is part of lifestyle modification while 60% are unaware of the need for moderation of alcohol intake. More than 80% are unaware of the roles of vegetables, fruits, unsaturated oil and reduction in diary food intake in the control of BP. Among 88 participants with some knowledge of salt restriction, 68.2% practiced it. This also applied to 8.6%, 7.5%, 32.3%, 12.9% and 6.5% of those with knowledge of regular exercise, weight reduction, alcohol moderation, fruit intake and cigarette smoking respectively. There was a negative correlation between the level of practice and both systolic and diastolic blood pressures. Conclusion: Awareness level and practice of lifestyle modification in blood pressure control among the studied cohort is poor. Concerted strategies need to be taken to improve these.