Abstract: Background: Hypertension is a major modifiable risk factor for cardiovascular, cerebrovascular and renal disease. Facility-level studys of blood pressure control and routine documentation can identify practical gaps in chronic disease care. Methods: A retrospective record-based study was conducted using 189 hypertension clinic records from Base Hospital Muthur, Sri Lanka, reviewed during August–September 2026. The latest documented systolic and diastolic blood pressure values and selected indicators of comorbidity assessment, investigations, lifestyle advice, follow-up and referral/complication status were extracted. Blood pressure was classified as controlled when systolic blood pressure was <140 mmHg and diastolic blood pressure was <90 mmHg. Descriptive statistics and exploratory chi-square tests were used. Results: The mean age was 45.25 ± 14.53 years (range 19–72). Of 188 records with sex documented, 133 (70.7%) were female. Mean systolic and diastolic blood pressures were 133.47 ± 23.28 mmHg and 75.79 ± 13.67 mmHg, respectively. Overall, 119/189 (63.0%) patients had blood pressure <140/90 mmHg and 70 (37.0%) were uncontrolled. Diabetes was documented in 85 (45.0%) records and CKD in 49 of 188 records with valid CKD status (26.1%). Creatinine was documented in 123 of 188 evaluable records (65.4%), glucose/HbA1c in 109 (57.7%), lipid profile in 139 (73.5%), urine investigation in 133 (70.4%), and lifestyle advice in 100 (52.9%). A next clinic date was documented in all 189 records; 59 (31.2%) had a missed scheduled follow-up. Blood pressure control was associated with sex in exploratory analysis (p=0.020), while no statistically significant association was identified with diabetes (p=0.758) or CKD (p=0.438). Conclusion: Approximately three in five patients included in the study had a latest documented blood pressure below 140/90 mmHg. Follow-up appointment documentation was complete, but opportunities remain to strengthen lifestyle counselling, laboratory