Background. Chronic kidney disease (CKD) is a progressive loss of the kidney function which leads to a decreased kidneys’ ability to process waste in the blood and it affects the other important functions of the kidney. The disease has different stages that can alter the health status of individuals. During the early stages, patients may present with a normal or slight decrease in glomerular filtration rate (GFR) and albuminuria. Later, it progresses and leads to end-stage renal disease (ESRD) or kidney failure. Hypertension is considered as the major contributing risk factor of CKD. Objective. This study was aimed to assess the prevalence and associated factors of chronic kidney disease among adult hypertensive patients in referral hospitals of the Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among 581 adult hypertensive patients in a chronic follow-up clinic in referral hospitals, Northwest Ethiopia, from July to August 2020. Systematic random sampling was used to select the study participants. Data were collected using the interviewer-administered questionnaire and participants medical records. Both bivariable and multiple logistic regression analyses were performed. Model fitness was assessed using a Hosmer—Lemeshow test. Result. The total prevalence of CKD among adult hypertensive patients was 17.6% (95% CI: 14.7–20.8). Diastolic blood pressure ≥90 mmHg (AOR = 8.65; 95% CI: 4.77–15.68), duration of hypertension ≥10 years (AOR = 8.81; 95% CI: 2.47–31.45), stage II HTN (AOR = 2.61; 95% CI: 1.04–6.50), comorbid disease (AOR = 7.0; 95% CI: 2.20–22.21), proteinuria (AOR = 4.59; 95% CI: 2.08–10.12), dyslipidemia (AOR = 3.40; 95% CI: 1.56–7.24), and serum creatinine ≥1 mg/dl (AOR = 8.88; 95% CI: 4.40–17.91) were associated with chronic kidney disease among adult hypertensive patients. Conclusion. In this study, the prevalence of CKD among hypertensive patients found was 17.6%. Regarding associated factors, dyslipidemia, proteinuria, comorbid disease, serum creatinine greater than 0.9 mg/dl, duration of hypertension greater than 10 years, and diastolic blood pressure greater than 90 mmHg are factors associated with the occurrence of chronic kidney disease among hypertensive patients.