Background: Hypertension is a preventable cause of premature death worldwide. Data from the Egyptian National Hypertension Project (NHP) revealed that hypertension is a significant problem among Egyptians. We studied the prevalence of hypertension, related risk factors and its complications in Fayoum governorate. Patients and Methods: This study included 2800 Egyptian participants aged 18 to 60 years old from Fayoum governorate selected randomly from different places in Fayoum governorate. Blood pressure was measured for them. Re-measurement for those with BP measurements ≥ 140/90 was done with a further assessment. Known hypertensive patients were thoroughly evaluated by clinical examination and laboratory investigations. Results: Our survey revealed that the prevalence rate of hypertension in Fayoum governorate was 28.4% (19.3% were aware and 9.1% were first diagnosed and unaware of their hypertension), 11% of the study population were pre-hypertensives. Poorly controlled hypertensive patients were 59.9%. Of all hypertensive patients, 63.4% of them were females, 87.9% of them were overweight and obese, while 26.3% of them had diabetes mellitus. Also, 41% of known hypertensive patients had complications. Conclusion and Recommendations: There is a high prevalence rate of hypertension in Fayoum governorate. More knowledge is required to reveal the reasons behind this high prevalence in addition to the low levels of control and awareness of hypertension, to put the appropriate strategy to improve the rate of control, awareness, and quality of life of hypertensive patients in Egypt.