Hypertension is a major global health concern, affecting over 1 billion individuals worldwide. Medication adherence is crucial for effective blood pressure control and reducing cardiovascular risk. However, poor adherence to antihypertensive medications is common, particularly in patients with apparent treatment-resistant hypertension. This comprehensive literature review aims to identify the prevalence, factors, and effective interventions associated with medication adherence among hypertension patients. The prevalence of medication non-adherence ranges from 20-50%, with higher rates observed in developing countries. Poor adherence is linked to increased hospitalizations, mortality, and healthcare costs. Factors influencing medication adherence can be categorized as patient-related (e.g., age, education, health literacy), healthcare provider-related (e.g., physician-patient communication, medication counseling), and system-related (e.g., healthcare access, insurance coverage, medication costs). Effective interventions to improve medication adherence include patient education, reminder systems, pharmacist interventions, mobile health applications, and financial incentives. Multifaceted, tailored, and technology-based interventions have shown promising results. Challenges in improving medication adherence include the complex nature of adherence behaviors and the need for personalized approaches. Future directions should focus on developing and implementing evidence-based, patient-centered interventions that address the multidimensional factors influencing medication adherence in hypertension patients. Improving medication adherence has the potential to significantly reduce the global burden of hypertension and its associated cardiovascular complications.