Background: Globally, Hypertension is the leading cause of early death and disability, and accounts for 9.4 million deaths every year. It is more prevalent in low- and middle-income countries, because more people live in those countries than in high-income countries. Limited studies had been done in the Eastern part of Amhara Region despite the epidemic proportion of Hypertension in the national level. Objective: To determine the prevalence and associated factors of hypertension among adults age 25 and above years in Kemisse Town, Eastern Amhara Region, Ethiopia, 2019. Methods: Community based cross-sectional study was conducted among adults aged 25 year and above in Kemisse Town from March 27- May 16/2019. A total of 880 subjects were included in the study using multi-stage sampling technique. Data were collected by structured pre-tested questionnaires, measurement of Blood pressure, resting heart rate, waist circumference and weight and height by trained clinical nurses. Epi Info version 7statistical software was used for data entry and Statistical package for social sciences (SPSS) version 20 for data analysis. Both simple and multiple logistic regressions were done. In multivariable analysis P-value of less than 0.05 was used as statistical significant. Results: Over all the prevalence of hypertension was 43.1% with 95 % Confidence interval (CI) (39.3- 46.5). The factors associated with hypertension were found to be family size 4-6[adjusted odd ratio (AOR)=5.276; 95%CI (2.745 -10.142)], and more than 7 [AOR=3.148;95%CI(1.82-5.44), being overweight [AOR=6.4; 95%CI (1.1- 37)], being not doing exercise[AOR=2.3; 95%CI (1.6- 3.4)], resting heart rate 80-90bpm [AOR= 1.92; 95%CI (1.3- 3.04)], monthly income high [AOR=3.0;95%CI(1.3-6.9], active tobacco users[AOR=4.8(1.2-19)] and Khat users[AOR=2.6;95%CI(1.4-4.4)] were significantly associated with hypertension. Conclusion and recommendation: prevalence of hypertension is high and having high family size, overweight, not doing exercise, active tobacco users, high family income, having high resting heart rate, tobacco users& Khat chewer were significantly associated with hypertension. Awareness creation should be strengthened to reduce prevalence of hypertension. Keywords: Hypertension, prevalence, associated factor, Kemisse