Introduction: The prevalence of hypertension in the elderly is increasing worldwide. Non adherence to medication in elderly is a major concern which is associated with adverse outcomes. Non adherence to medications is a complex issue hence this study is undertaken to study factors affecting for non adherence to medications in elderly hypertensive patients. Materials And Methods: This retrospective study included 270 elderly patients i.e. (>60 years) after screening among out patients visiting general medicine and geriatric departments of BMCRI, Bangalore. Complete physical examination, BP measurement and the reasons for non adherence were assessed from patients. Results: Total of 270 patients, majority were in the age group of 60-70 years (63.3%). Males and females were 60% and 40%.The duration of hypertension was more in the range of 10-15 years (36%), followed by 15-20 years in (33.3%).The common reasons for non adherence was“ the high cost” in 22% and “too many tablets to consume” in 18.7% of patients. Remaining 16% “did not understand the importance” in taking medication, about 13% of due to its “side effects” around 9% due to “forget fullness” and 6% stopped medications as they were “asymptomatic”.Conclusion: The problem of non-adherence to medications is universal in patients with hypertension. The main reasons are poly pharmacy and increased cost in our study. Others include poor consultation, forgetfulness in elderly patients. Regular and repeated consultation especially establishment of “hypertensive clinics” will go a long way to improve the adherence to treatment protocol in hypertension patients.