OBJECTIVES: To understand current medication compliance status of hypertension and its associated factors in urban China. METHODS: A community-based hypertension health survey was conducted in 2 cities of China (Beijing and Hangzhou) from Nov 2011 to Aug 2012. 10 community health service centers in each city were selected through cluster sampling. Hypertension patients who registered in the study sites were recruited by field investigators using standardized questionnaires. Patient data were collected including socio-demographic characteristics, disease profile, treatment pattern, and health education awareness. Medication compliance was assessed by Morisky score. Self-reported health utility and social support scale instruments were also employed. Logistic regression and multivariate analysis were used to explore the associated factors affecting medication compliance in hypertension. RESULTS: In total, 1006 patients with hypertension were included, with average age of 65.26±11.27 years old. 40.85% were male. The average duration of hypertension is 12.35±10.27 years. 761 patients (75.65%) managed to control blood pressure under 140/90 mmHG based on last blood pressure detected. 89.76% of the study subjects had less than 3 complications. Results show that 67.1% subjects achieved high level of compliance, 25.94% were moderate compliant, and 6.96% were non-compliant. The main influential factors of non-compliance were forgetting to take medicine (57.1%) and self-awareness of disease remission (32.6%). Multivariate analysis showed that compliance was positively associated with age, disease duration and social support, while negatively associated with existence of hypertension complications. Household income and reimbursement status were not major factors affecting medication compliance. Patients with high level of compliance also reported to have better health utility scores. CONCLUSIONS: The compliance status in hypertension in urban China is relatively poor. Strengthening family support and implementing effective health are important to improve medication compliance in hypertension, which may lead to improved patient reported outcomes.