OBJECTIVES: The objective of the study was to determine costs and clinical outcomes of antihypertensive treatment patients taking amlodipine or telmisartan. METHODS: This year long prospective observational study was carried out at cardiology OPD of a private tertiary healthcare hospital. The patients over 20 years of age, either sex, with clinically diagnosed hypertension (JNC VII) receiving either telmisartan (40 & 80 mg OD) or amlodipine (5 mg OD or BD) were followed for a period of at least 8 weeks after baseline assessment. An attempt made to understand the direct costs involved. The primary outcome measured was difference in SBP and DBP after 8 weeks of treatment vs. baseline BP. Only the direct costs were included. RESULTS: Of 250 patients studied, 120 belonged to the amlodipine and 130 to the telmisartan group. 150 had a family history of hypertension. The average systolic and diastolic BP was 153.90±15.7 and 93.36±7.1 mmHg, respectively. Age, weight, height, BMI, Baseline SBP and DBP and duration of hypertension did not differ in between amlodipine and telmisartan group. The prevalence of CAD was more in male patients; and, the prevalence of diabetes was more in female patients. The average reduction in SBP was amlodipine and telmisartan group was 17.92±10.2mmHg and 18.48±13.6 mmHg. The average DBP reduction found in amlodipine and telmisartan group were 9.45±7.3 and 10.3±6.9 mmHg. However, at the end of the minimal follow up period, there was no statistically significant difference found in reduction of DBP. BP control was significantly different in diabetic and non-diabetic patients. The average cost of drugs per mmHg reduction of BP was INR973 and INR812 in amlodipine and telmisartan arms, respectively, in non-diabetic hypertensive patients on monotherapy. CONCLUSIONS: Despite its limitations, the results offer indicative evidence using the real-time Asian Indian patients.