Background: Lifestyle modifications are behavior focusing on reducing weight, reducing dietary sodium intake, engaging in physical activity, and moderating alcohol consumption. A crucial element in controlling high blood pressure is lifestyle modification. However, only a few studies specifically address the question of hypertensive patients' compliance with physicians' recommendations for a healthy lifestyle. Objectives: To assess lifestyle modification practice and associated factors among people with hypertension attending chronic follow-up units in Oromiya special zone public hospitals,amhara,Ethiopia,2020. Methodology: Facility based cross-sectional study was conducted from March 20-April 20/2020 in Kemise general and Bati primary hospitals. Total of 433 hypertension patients in both hospitals were included in the study. Interviewer administered structured questionnaire was used. Descriptive statics like mean, percentage and proportion were used to summarize the result. The data were analyzed using SPSS version 20.0. Bivariable logistic regression analysis was performed. In the multivariable analysis p < 0.05 was considered to measure statistically significant associations and the strength of association was determined using odds ratio with 95% confidence interval. During data collection, close supervision was made by the supervisor. Result: About 52.7% (95%CL: 48%-57.4%) participants had poor lifestyle modification practice for last one week. Monthly income(AOR=3.091,95%CI:1.644,5.811),widowed(AOR= .396, 95% CI: .173, .905),educational status degree and above(AOR =4.238, 95% CI: 1.385, 12.966),patients who had family history of HTN (AOR=.569, 95%CI:.341,.949) and poor self efficacy(AOR=.134, 95% CI:.072,.249 ) were associated with lifestyle modification practice. Conclusion: Lifestyle modification practice was 52.7%. Average monthly income and educational statues was significantly associated preventive factors for lifestyle modification practice. Marital status, family history of hypertension and self efficacy was significantly associated risk factors for lifestyle modification practice. Keywords, lifestyle modification practices, Ethiopia, hypertension. List of abbreviations and acronyms