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Background: Worldwide, around 1.28 billion adults, aged 30–79 years have hypertension (HTN) and most (two‑thirds) of them living in low‑ and middle‑income countries like India. While only less than half of adults (42%) with HTN are diagnosed and treated. This study is an effort to estimate the prevalence and determine the determinants of HTN among the rural elderly population in Tigira block, Cuttack district of Odisha. Methodology: This cross‑sectional study was carried out among 725 rural elderly (>60 years) people using probability proportionate to sample (PPS) sampling in the year 2019–2020. Previous medical history of HTN diagnosed by medical professional was taken as positive for HTN. Bivariate analysis was performed using the Chi‑square test. The binary logistic regression model was used to find out the predictors of HTN. Results: This cross‑sectional study found an HTN prevalence of 34.75% (n = 252) among rural older adults. Factors found to be significantly associated with HTN were female gender (adjusted odds ratio [AOR] = 1.73, confidence interval [CI] = 1.129–2.666), elderly aged ≥80 years (AOR = 1.98, CI = 1.170–3.379), not working elderly (AOR = 2.14, CI = 1.178–3.89), lower‑middle socioeconomic status (SES) (AOR = 1.61, CI = 1.093–2.372), overweight elderly (AOR = 2.01, CI = 1.309–3.098) and diabetics (AOR = 4.56, CI = 2.704–7.718), respectively. Conclusion: HTN prevalence was found to be high in the rural area, and the factors such as female gender, elderly aged ≥80 years, not working elderly, lower‑middle SES, overweight elderly, and diabetes were found to be the determinants of HTN in the rural elderly population of Odisha. [ABSTRACT FROM AUTHOR]