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To determine medication related problems and its predictors among hypertension patients on chronic follow-up at Jimma Medical Center.Methods: A prospective interventional study was conducted among hypertension patients from November 28, 2021 to June 30, 2022 at Jimma Medical Center. Medication related problems were classified and identified based on Pharmaceutical care network Europe drug classification tool version 9.0. Interventions were done through discussion with individual prescriber and patients. Consecutive sampling technique was used. Binary Logistic regression was used to identify independent predictors of medication related problems. Variables having P-values < 0.05 were considered statistically significant.Results: Among 384 hypertension patients included in the study, 219 (57.1%) were male. The mean (SD) age was 49.06+17.79. Two thirds of study participants had at least one medication related problem. A total of 483 MRPs were identified among 231 (60.15%) patients. Treatment effectiveness related problem (55.48%) was the most common observed medication related problems. Alcoholism (AOR; 3.15, 95% CI [1.46– 7.23]), stage II hypertension (AOR=2.77, 95% CI= [3.53– 4.66]); comorbidity (AOR=2.88, 95% CI= [1.47– 5.66]) and polypharmacy (AOR=3.07, 95% CI= [1.57– 5.99]) were the independent predictors of medication related problems.Conclusion: The prevalence of medication related problems was high among hypertensive patients. Alcoholism, stage II hypertension, comorbidity and poly-pharmacy were the predictors of medication related problems. Therefore, to overcome the problems, clinical pharmacists, physicians and other health care professionals have to work in collaboration. [ABSTRACT FROM AUTHOR]