Background: Hypertension is a significant global health issue, disproportionately affecting the elderly population. In Poland, the rapid aging of the population underscores the need for updating data on the epidemiology of hypertension in the elderly., Aims: This study aimed to investigate the prevalence, awareness, treatment, and control of hypertension among individuals aged 65 and older in Poland., Methods: The NOMED-AF study, a cross-sectional survey conducted from March 2017 to March 2018, enrolled a representative sample of 3014 participants aged 65 and over, using a multistage, stratified, and clustered sampling method. Data collection included standardized questionnaires and physical measurements carried out by trained nurses. Hypertension was diagnosed per the 2018 European Society of Hypertension/European Society of Cardiology guidelines., Results: The study showed a hypertension prevalence of 82.5% in females and 78.3% in males aged 65 and older. Awareness of hypertension was high across all age and sex groups, with 86.2% of women and 83.4% of men being aware of their condition. Treatment rates were 84.8% in women and 80.5% in men. Optimal control of blood pressure among those treated was achieved in 40.3% of women and 45.6% of men. Women over 80 achieved optimal blood pressure control less frequently than men., Conclusions: The results highlight the high prevalence and suboptimal control of hypertension in Poland's elderly population, pointing to a significant public health challenge. Despite high rates of treatment, management of hypertension remains inadequate, which emphasizes the need for enhanced strategies in hypertension care, particularly for elderly women.