Introduction: Hypertension contributes to major cardiovascular morbidities and mortalities worldwide and medica- tion compliance is crucial in achieving target blood pressure control. This study aimed to determine the prevalence and factors associated with non-compliance towards anti-hypertensive medication in Malaysia. Methods: This is a cross-sectional study among hypertensive patients who were attending the medical outpatient department, Hospital Serdang from March until May 2018. Systematic random sampling was used to recruit patients and a structured self-administered questionnaire was used to collect information. Non-compliance is defined as attaining a score of 26 and below from the Medication Compliance Scale. Data analysis was done using SPSS v. 23. Multiple logistic regression was used to determine the predictors of medication non-compliance among hypertensive patients. Re- sults: A total of 120 respondents were recruited into this study with a response rate of 60.9%. Mean age of the study respondents was 60.82 ± 11.25 years old. They were predominantly female (60.8%), Malay (58.3%) and attained at least secondary educational level (75.0%). The prevalence of non-compliance towards anti-hypertensive medi- cation was 25%. Multiple logistic regression showed that side effects of medication (OR=5.59; 95% CI=1.29-24.21, p=0.021), traditional medications usage (OR=19.19; 95% CI=3.90-94.45, p=