Background: Poor self-care practice leads to uncontrolled hypertension.Globally uncontrolled blood pressure caused 9.4 million complications and (17) million deaths.Therefore, this study was aimed to assess the level of self-care practices and associated factors among hypertension patients in public hospitals of Hawassa city. Methods and materials: A facility based cross-sectional study was conducted at selected public hospitals in Hawassa city from Febroury 6 to May 5, 2023. A systematic random sampling technique was used to select study participant from each hospital. Data collected by kobo collect statistical tools and exported to SPSS version (25) for analysis. Binary logistic regression model was used to assess the association between dependent variables and independent variables. The result of final model was presented as adjusted odds ratio with 95% confidence interval. Variables having a 95% confidence interval that does not include one (1) in the final model were considered independent predictors of good self-care practice among hypertensive patients. Adjusted odds ration with 95% confidence intervals were reported. Result: Male participants were 66% less likely to practice poor self-care practices of hypertension compared to females participants (AOR = 0.44, 95% CI: 0.26, 0.75). Those participannts age group between 60–99 had 4.11 times higher odds of poor self-care practice compared to the participants of age group of 18–39 (AOR = 4.11, 95% CI: 1.98, 8.53), less than five years since being diagnosed with hypertension were 3.14 times more likely to practice poor self-care compared > five years (AOR = 3.14 (1.85, 5.32), Patients who have comorbidity (AOR = 2.05, 95% CI: 1.12, 3.73), Patients who chewed khat (AOR = 2.45, 95% CI: 1.27, 4.73), and those who were not employed had 1.90 times higher odds of poor self-care practice of hypertension compared with those employed participants (AOR = 1.90, 95% CI: 1.16, 3.10). Conclusion and recommendation: Half of the respondents have poor self-care practices among hypertensive patients. We identified significant factors associated with poor self-care practices among hypertensive patients including: sex, Age, occupation, chewing khat, <5years since diagnosis, and patient with comorbid. We recommended policymakers, the regional bereou; healthcare workers and researchers work on the identified factors of poor self-care practice of hypertensive participants in the study settings.