Objective: To investigate the levels of understanding and implementation of current hypertension guidelines among specialist physicians. Subjects and Methods: A survey of the understanding and practice in the management of hypertension was conducted among 56 physicians who individually had managed more than 150 new hypertensive patients annually. Results: All respondents were familiar with the current hypertension guidelines and 51.8% always or usually followed these guidelines in treating their patients. Most believed that the lowest blood pressure where pharmacological therapy should be initiated was 155/95 mm Hg. Forty-five (80.4%) physicians considered a blood pressure of less than 140/ 90 mm Hg should be achieved in hypertensive patients. Only 12 (21.4%) respondents provided routine advice on lifestyle modification to their patients. Fifty-four (96.4%) respondents ranked poor adherence to antihypertensive drugs as the major patient barrier to blood pressure control. Conclusions: Most physicians are familiar with the current hypertension guidelines but the implementation of these guidelines in clinical practice is inadequate. Systematic educational programs are needed to enhance physicians' awareness of the optimal goals of blood pressure control.