Hypertension is the most common cause of cardiovascular diseases, accounting for at least half of haemorrhagic and ischaemic strokes, heart failure and renal failure in sub-Saharan Africa. However, population-based data to inform policies are scarce. Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based nationwide survey was conducted on participants aged 25-64 years in Malawi. Detailed findings on the burden of hypertension are presented in this paper. Blood pressure (BP) was measured in 3727 participants. The age-standardised prevalence of hypertension (BP ≥140/90 mmHg) was 33.2% (95% CI 30.9-35.6%). Hypertension was more frequent in males than females (36.9% vs 29.9%), alcohol drinkers than non-drinkers (40.9% vs 31.6%), overweight than non-overweight (41.5% vs 30.7%) and increased with increasing age (21.4% in 25-34 years old vs 59.2% in 55-64 years old). Three-quarters of the participants said they never had their BP measured before and 94.9% of those with hypertension said they were not aware that they had such a medical problem. High prevalence of hypertension and its risk factors calls for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases to promote healthy lifestyles, early detection, treatment and control.