BackgroundUncontrolled blood pressure is an important medical and public health problem in developing countries like Ethiopia. Improving the management of hypertension requires a better comprehension of the factors influencing blood pressure control and the application of interventions. But in clinical practice, blood pressure is still not adequately controlled. Thus, this study aimed to assess uncontrolled blood pressure and associated among adult hypertensive patients on follow-up at public health facility ambulatory clinics in Bishoftu, Ethiopia.MethodsA hospital-based cross-sectional study was conducted among 398 adult hypertensive patients who were on treatment and follow-up from April to May 31, 2022. Systematic random sampling was used to select study participants. Data were collected using an interviewer-administered, semi-structured questionnaire and chart review. The Eighth Joint National Committee (JNC 8) criteria was applied to define blood pressure control status. Binary logistic regression analysis was used to model the association between dependent and independent variables. An adjusted odds ratio and 95% confidence interval were used to measure the strength of the association. Finally, at ap-value < 0.05, statistical significance was proclaimed.ResultOf the total study participants, 249(62.6%) were male. The mean age was 62.26 ± 11.55 years. The overall proportion of uncontrolled blood pressure was 58.8% (95% CI: 54–64). Salt intake (AOR = 2.51; 95% CI: 1.49–4.24), lack of physical activity (AOR = 1.40; 95% CI: 1.10–2.62), habitual coffee consumption (AOR = 4.52; 95% CI: 2.67–7.64), higher BMI (AOR = 2.08; 95% CI: 1.24–3.49), and non-adherence to antihypertensive medications (AOR = 2.31; 95% CI: 1.3–3.89) were independent predictors of uncontrolled blood pressure.ConclusionMore than half of the hypertensive patients in this study had uncontrolled blood pressure. Healthcare providers and other accountable stakeholders should urge patients to follow salt restriction, physical activity, and antihypertensive medication regimes. Reduced coffee consumption and weight maintenance are other crucial blood pressure control measures.