ObjectiveTo examine the association between hysterectomy and hypertension among middle-aged and older women in India, as well as to determine if the association differs across different age groups.DesignA cross-sectional exploratory study.Setting and participantsNationally representative population-based data of the Longitudinal Ageing Study in India (2017–2018) were used in this study. The sample included 32 460 women aged 45 years and above.Outcome measuresSelf-reported hypertension was the outcome variable. The variable was a binary variable, with 1 representing hypertensive and 0 representing not hypertensive.MethodsEntropy balance method, along with logistic regression analysis, was used to meet the objectives.Results31.3% of the women with hysterectomy and 42.5% of the women without hysterectomy were hypertensive. A perfect covariate balance was achieved between the treatment and control groups using the entropy balance method. Women with hysterectomy had 36% (OR 1.36; 95% CI 1.26 to 1.48) higher odds of hypertension than women without hysterectomy. The OR was 1.23 (95% CI 1.03 to 1.47) for the age group 45–49, whereas, for the age group 80+, it was 1.87 (95% CI 1.18 to 2.97), showing that the magnitude of the association between hysterectomy and hypertension varied with age.ConclusionThe findings of this study suggest that hysterectomy and hypertension have a significant association in middle-aged as well as older women in India.