BACKGROUND: Hypertension among patients with type 2 diabetes results in higher rates of cardiovascular complications and deaths. However, there is limited data on the prevalence of hypertension and its associated factors among patients with type 2 diabetes in Afghanistan. OBJECTIVE: Our study aims to determine the prevalence of hypertension and its associated factors among patients with type 2 diabetes in southern Afghanistan. METHODS: This was a multi-center hospital-based cross-sectional study employed from January to June 2024 in southern Afghanistan. A total of 609 randomly selected patients with type 2 diabetes were included in the analysis. Diabetes patients were examined for the presence/absence of hypertension diagnosis using a criterion set by the American Heart Association. The binary logistic regression analysis was performed to test for risk factors associated with hypertension among patients with type 2 diabetes. RESULTS: Among the 609 patients with diabetes included in the study, 55.3% (95% CI: 51.2%-59.3%) had hypertension. According to the results of binary logistic regression, female gender [AOR, adjusted odds ratio =1.73, 95% CI (1.09-2.74)], age of CONCLUSION: Due to the high prevalence (55.3%) of hypertension among patients with type 2 diabetes in Afghanistan, it is imperative to develop targeted interventions aimed at early detection and ensuring adequate care, especially for those most at risk for hypertension.