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The high number of hypertension cases is due to the still low level of hypertension control, specifically medication adherence. Treatment adherence is crucial for maintaining health and well-being in patients with hypertension. In contrast, non-adherence to medication leads to treatment failure. This study aims to determine the relationship between self-management and adherence to hypertension medication in the elderly. This research employed an analytical design with a cross-sectional approach. The study consisted of 49 elderly people with hypertension in Cot Cut Village, Kuta Baro, Aceh Besar. The sample was chosen using a total sampling technique. The MMAS-8 questionnaire was used to assess adherence to hypertension medication with a Cronbach's alpha of 0.860. The self-management questionnaire showed a Cronbach's alpha of 0.766. The research was conducted from April 8th to 14th, 2025. The data analysis used univariate and bivariate methods, using the chi-square test. The results showed that out of 49 respondents, 21 (42.9%) were less adherent to hypertension medication, and 29 (59.2%) had less adherence to self-management. The chi-square test indicated a p-value of 0.001, showing a relationship between self-management and adherence to hypertension medication among the elderly. This research suggests that hypertensive patients should be supervised to improve medication adherence and self-care management to maintain stable blood pressure.