Hypertension is a risk factor for cardiovascular disease. Several studies have shown that control of hypertension is still low, and the main reason is the low medication adherence to taking medication for patients, especially in rural areas. It can lead to treatment failure, consequently increasing morbidity and mortality. The purpose of this study is to describe the adherence to medication and observance the characteristics of hypertensive patients in rural areas. A cross-sectional design is used in this study. It was adopted to facilitate the survey of hypertensive patients in rural areas. This research was conducted in several districts in the city of Pekanbaru which is a rural area. The sample consisted of 220 patients with hypertension using the quota sampling technique. The characteristics of patients were measured using a validated questionnaire, and patient adherence was measured by the MGL (Morisky, Green and Levine) adherence scale. The results of the study involving 220 respondents showed that the majority of respondents were women, with an age range of 45-59 years (middle age) and with a low level of education (elementary school graduates). The duration of illnesses was >1-5 years with the majority (50.9%) of patients having a low level of medication adherence. There is no association between patient’s characteristics and adherence. Adherence to taking medication for hypertensive patients in rural areas is low. Pharmacists need to give full attention and think of appropriate interventions to increase patient adherence with medication in rural areas.