Introduction: Hypertension is one of the top non communicable disease in Saudi Arabia. The prevalence of hypertension was 26.1% in crude terms. For males, the prevalence of hypertension was 28.6%, while for females; the prevalence was significantly lower at 23.9%. Patients' awareness is important in the early diagnosis and treatment of many diseases including hypertension. This study contributes in exploring the awareness of hypertension among Saudis population in Al-Madinah Al-Muonawwara. Objective:To estimate prevalence, awareness, treatment adherence and associated factors of hypertension among Saudi aduly population in Al-Madinah. Methods: Cross-sectional design with multistage cluster stratified sampling was used to include 451 Saudi adults participants in the study. Self administered questionnaire was piloted and used to collect the required data. Data were analyzed using SPSS version 16. Univariate analysis was done and cross tabulation was used to summarize the frequency and percentage of the variables. Chi-square was used as an appropriate statistical test and P≤ 0.05 was used as a statistical significant level. Multiple regression was used to control for confounders and assess the risk factors. Results: 15% of the participants has hypertension. Among those with hypertension 77% (50/65) has good knowledge and awareness of hypertension. Approximately half of the participants had changes their life style, 43% (28/65), and had irregular follow up with their doctors, but one third of them did not adhere to their treatment. After adjustment of the confounding factors, hypertension was increased two times by existing of family history of hypertension and higher level of education (PhD holders), (odds ratio =1.99, 95%CI (1.002, 3.96) and (2.05, 95%CI=1.06, 3.99) respectively. Conclusion: Hypertension prevalence was high in Al-Madinah community. Those with hypertension have good awareness about the disease but one third of them did not adhere to third treatment. A control program of hypertension is of utmost important to be established in Al-Madinah.

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