Dissertation (MSc Public Health)Hypertension is a serious public health problem in Tanzania. Adherence of the recommended self-care practices is beneficial against poor health outcomes and health care expenditures among hypertensive patients. This study assessed the self-care practices, lifestyle behaviors and cost Evaluation among adults attending hypertension clinics in selected hospitals in Tanzania. A mixed approaches cross-sectional study involved 329 participants carried from June to September 2020. An interviewer questionnaire was conducted to 311 patients. The in-depth interviews with 18 informants were conveniently sampled in clinic visit at Dodoma and Amana Regional Referral Hospital. Self-care practices were assessed by H-SCALE endorsed by the Seventh Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). The lifestyle behaviors and cost evaluations were assessed by WHO steps survey standard questionnaire. The SPSS, version 26 was used while the audio records were transcribed and coded depending on themes of the study. The mean age of hypertensive patients was 53.6 ± S.D 7.5 years. Females were 58.8%. Only 17.7% had good compliance with recommended lifestyle behaviors related to hypertension. Regular physical activities were 37.9% adhered and22.2% adhered the consumption of fruits and vegetables. The hypertensive patients 71.1% had adequate knowledge of self-care practices. Overall, 25.1% of the hypertensive patients had good self-care practices. The study revealed that patients with family history and adequate knowledge were more likely have good self-care practices (AOR=2.517, CI=95%, 1.255-5.045,p-value 0.009), (AOR=2.776, CI=95%, 0.818-5.399, p-value 0.003). Hypertensive patient’s catastrophic health expenditure was 8.4%. The total cost payments in the form of out of pocket were 183216Tsh (US$ 79.35) per year. Majority of hypertensive patients had poor self-care practices and low compliance with the recommended lifestyle behaviors. This finding shows a need for health promotion interventions and increases the health insurance coverage.