OBJECTIVES: The prevalence of hypertension is increasing in epidemic proportions in the Indian subcontinent. Despite the well known benefits of aggressive blood pressure control in hypertensive patients, data from the subcontinent indicate that the control of hypertension remains remarkably poor. Our previous study demonstrated that calcium channel blockers (CCBs) were the most prescribed agents for uncomplicated hypertension in three South Indian Hospitals. The objective of this study was to assess the physician’s perspectives with regard to antihypertensive pharmacotherapy and to determine whether they are in accordance to national and/or international hypertension guidelines. METHODS: A questionnaire was developed containing questions on familiarity with guidelines, diagnosis of clinical hypertension, and evaluation of patients with hypertension with or without co-morbidities, treatment of hypertension including choice of drugs, and drug regimens or specific drug combinations. The questionnaire was administered to interns and physicians of Medicine Department of three teaching-hospitals in South India. RESULTS: Among a total of 57 physicians who received the survey 58.1% expressed familiarity with the JNC-VII guidelines whereas 12.8% were familiar with the Indian Hypertension Guidelines-II. Although majority of the physicians were aware of the guidelines about 37% of them indicated that they would prefer CCBs as the first drug for treating uncomplicated hypertension. When asked about monotherapy versus combination therapy a majority (91.2%) of the physicians chose a two-drug combination over monotherapy. CCB with ACE-inhibitors was the most favored choice followed by combinations of CCBs with beta-blockers and diuretics.  CONCLUSIONS: The physician’s preference of CCBs and combination therapy over other antihypertensives and monotherapy may be attributed to the better treatment outcomes they experienced and is consistent with emerging trends observed in recent studies such the ACCOMPLISH and ASCOT trials that underscore the benefits of using combination therapy with CCBs as initial therapy for hypertension.