Background: This study aimed to assess the prevalence, associated factors and awareness of hypertensive retinopathy among an elderly population with hypertension in Nepal Methods: A population-based, cross-sectional study was conducted from 2013 to 2015 in Bhaktapur district, Nepal. The sample size was 2100 subjects age 60 years and above. From this sample, all diagnosed patients with hypertension were analyzed. A detailed history was obtained, and an ocular examination was performed. Blood sugar and blood pressure were measured. Result: Information was complete for 1860 (88.57%) subjects. The age ranged from 60 to 95 years with the mean ± SD age of 69.64±7.31 years. Hypertension was found in 643 subjects (34.61%), of which 224 (12.04%) were newly diagnosed cases. Hypertensive retinopathy was found in 81 cases (12.6%). Grade 1, grade 2, and grade 3 hypertensive retinopathy comprised 53 (65.43%), 19 (23.46%), and 9 (11.11%) cases, respectively. Hypertensive retinopathy was more frequent in the age group 70-79 years (15.23%) compared to other age groups, among males (13.25%), illiterates (13.56%), diabetics (16.49%), and those with body mass index (BMI) ≥25 kg/m2 (14%). However, none of the factors was found to be statistically significant. Among the subjects with hypertension, awareness of hypertension’s effects on the eyes, retina and vision was found in 13.84%, 8.4%, and 11.98% respectively. Conclusion: Prevalence of hypertension, hypertensive retinopathy and associated factors among an elderly population were similar to other countries. Awareness of hypertensive retinopathy was found in only 8.4%. Increased emphasis should be directed toward improving awareness campaigns. Key words: Hypertension, hypertensive retinopathy, elderly, awareness, Nepal