Abstract: This study assessed the pattern of presentation of hypertensive patients in the clinic at Aminu Kano Teaching Hospital (AKTH) Kano, North western Nigeria, determined the level of control of hypertension in these patients and the drugs used for this purpose. A cross sectional retrospective study was conducted using case notes of 200 randomly selected patients who attended the hypertension clinic of the AKTH, Kano. Data extracted included pattern of presentation, drugs prescribed, adherence to treatment and control of blood pressure among the population studied including diabetics in the cohort. The study population had a mean age of 50.7 with over 30% being over 60 years. The 60% were females. Diabetes mellitus was the most common comorbid ailment (13%) in the study population. Over 42 and 29.5% of the population presented with grade 3 and grade 2 hypertension, respectively. Over 80% of the patients were on combination therapy with over 42% of patients on at least 3 antihypertensive drugs. Diuretics were the most commonly prescribed drug group (34%) with the vasodilator, hydrallazine, the least prescribed. About 53% of the patients were reported to have been regular on their drugs. Blood pressure was fully controlled in 34.5% of all patients and in 23.1% of diabetic patients in the study population. Control of blood pressure in the study population including diabetics was low while a high level of non adherence and low socio-economic status was seen in this study population calling for the use of multiple approaches including treatment intensification, scaling up of patient and provider education and creative health system policy changes to address the problem.