<p>This study evaluated lifestyle modification practices and their associated factors among hypertensive adults in West Wollega Zone hospitals, Ethiopia. From 730(98 %) involving study participants found that only 31.37% practice recommended lifestyle modifications. Significant factors included: co-morbidity (AOR=14.19, 95% CI: 8.51-23.65), formal education (AOR=3.63, 95% CI: 2.14-6.15), urban residency (AOR=3.42, 95% CI: 2.12-5.52), median wealth index (AOR=3.98, 95% CI: 1.76-9.34), rich wealth index (AOR=1.94, 95% CI: 1.14-3.50), age ≥ 65 years (AOR=0.61, 95% CI: 0.38-0.99), receiving information from healthcare professionals (AOR=0.43, 95% CI: 0.34-0.94), and being on treatment for over ten years (AOR=0.13, 95% CI: 0.04-0.38). These findings underscore the need for targeted interventions to enhance lifestyle modification practice among hypertensive patients in the country.</p>