Abstract: OBJECTIVE To explore differences in medication adherence among Chinese patients with hypertension with different age groups, gender, measuring tools, economic level and educational levels. METHODS Three English databases (PubMed, Web of Science and Embase) and three Chinese databases (CNKI, WanFang and CQVIP) were used to retrieve the relevant literature published from January 2010 to September 2018. Random effect models were applied to calculate pooled effect size with 95% CI. Subgroup analysis was applied to identify potential sources of heterogeneity among these comparisons. RESULTS Final 27 papers were adopted including 20 140 participants from 14 provinces, 3 municipalities and 1 region. Results showed that the adherence rate of hypertension patients in China was 42.0%(95%CI:36.0%-48.0%). Subgroup analysis showed that the eight-item Morisky Medication Adherence scale value was 49.4%(95%CI:38.9%-59.9%). The four-item Morisky Medication Adherence Scale value was 37.5%(95%CI:31.1%-44.0%). Patients with educational levels of primary or below, secondary, and tertiary or above had adherence results of 49.5%, 49.6% and 53.6%, respectively. Male patients(47.5%) medication adherence was slightly lower than female(48.4%). The adherence rate of patients over 60 years of age(51.0%) was higher than that of patients under 60 years of age(46.9%). The medication adherence rate(48.3%) was higher than that(37.5%) in developed regions. CONCLUSION Medication adherence among Chinese patients with hypertension is relatively low. Different measuring tools may affect the results of medication adherence measurement. Education, gender and economic level are the influencing factors of medication adherence in patients with hypertension effective interventions are urgently needed to improve address and mitigate this problem.