Background: Hypertension is a prevalent health problem in older adults, with better outcomes expected through proper self-care. However, little is known about the effects of cognitive function level on self-care in older adults living in the community. Methods: This cross-sectional study, conducted from October 2019 to January 2020, analyzed the effect of cognitive function on self-care in elderly individuals aged > 65 years with hypertension who visited a local general hospital for the treatment of hypertension. The Korean versions of the Mini-Mental State Examination (K-MMSE) and Montreal Cognitive Assessment (MoCA-K) were used to assess cognitive function. The Hypertension Self-Care Behavior Scale (HBP-SC Behavior Scale) was used to analyze the subjects’ self-care, which was divided into diet behavior and health behavior (except diet). The general characteristics and degrees of self-care of the subjects were analyzed using descriptive statistics, and multiple regression analysis was used to analyze the factors affecting self-care. Results: Factors influencing HBP-SC diet behavior scores were religion (β =.27, SE = 0.69, p =.007) and MoCA-K scores (β =.31, SE = 0.08, p = .002). HBP-SC health behavior (except diet) scores were associated with comorbidities (β = −.20, SE = 0.60, p = .032), and the power of the model was 20%. However, there were no variables that significantly affected the total HBP-SC score, which included the diet behavior and health behavior (except diet) scores. Conclusions: Although there was no significant factor influencing the total HBP-SC score, religion, MoCA-K scores, and comorbidities were factors influencing diet behavior and health behavior (except diet). Therefore, tailored education takes into account religion, MoCA-K domains, and comorbidities is necessary to promote self-care in hypertensive older adults.