Background: Hypertension is a major cardiovascular risk factor, yet its control remains a global challenge. Effective management, through adherence to antihypertensive medications and lifestyle modifications, can significantly reduce cardiovascular morbidity and mortality. This study aimed to explore factors influencing treatment compliance among hypertensive patients using the Health Belief Model (HBM) framework. Objective: The study sought to assess treatment compliance among hypertensive patients and identify the influence of sociodemographic factors and HBM variables on adherence to antihypertensive therapy. Methods: A descriptive, cross-sectional study was conducted at Dhaka Medical College Hospital from January to July 2014, involving 200 hypertensive patients. Participants were selected using simple random sampling. Data were collected through structured questionnaires and analyzed using SPSS. Bivariate analyses (Chi-square and Pearson correlation) and multivariate linear regression were performed, with statistical significance set at P ≤ 0.05. Results: The mean age of participants was 56.3 (±13.1) years, with 56% showing treatment compliance. Among the participants, 56.5% were female, and 43.5% were male. Most had at least primary education, and 33% had no formal education. Regarding employment, 55.5% were unemployed. The bivariate analysis revealed significant associations between treatment compliance and HBM variables: perceived susceptibility, perceived benefits, perceived barriers, and cues to action. However, perceived severity did not show a significant association. Multivariate analysis indicated that perceived barriers were the strongest predictor of treatment compliance. Conclusion: The study found suboptimal treatment compliance among hypertensive patients, with perceived barriers being the most significant factor influencing adherence. Healthcare providers should emphasize health education on the lifelong need for antihypertensive treatment, and policies promoting free or subsidized medication could help improve compliance.