Objective To explore elderly patients with hypertension medication adherence and blood pressure target achievement and to propose nursing interventions. Method: 198 cases of elderly patients with hypertension were followed-up during hospitalization and after three mouths discharged from hospital by clinic or telephone. Medication adherence was evaluated by the MORISKY Recommended evaluation form. Results: The elderly patients with hypertension are prescribed medication well during hospitalization, but three months after discharge, the medication compliance and blood pressure target achievement are low. Conclusion: The elderly hypertensive patients with poor medication compliance and the rate of blood pressure control were lower. In order to improve medication adherence and blood pressure target achievement of elderly patients with hypertension, we should carry out active health education, establish a good nurse-patient relationship, give life care and medication guidance and rationally use the drugs, reduce adverse drug reactions.