Background and Objectives: Hypertension (HTN) is among the major health problems worldwide, despite this, many studies have shown that the control of high blood pressure (BP) is inadequate. This study aims to obtain insight into this issue and to assess to which extent an optimal BP can be achieved in Erbil, Iraq (a low-middle income country). Materials and Methods: This observational prospective study enrolled 200 hypertensive patients who attended the medical consultation room at Hawler Teaching Hospital, Erbil, Iraq from 1st February 2023 to 31st January 2024. Baseline demographic data, comorbidities, and relevant lab investigations were obtained, recorded, and analyzed. All participants underwent office BP measurements on four scheduled visits 1 month apart, and appropriate interventions were done. Results: Out of 200 participants, only 44 (22%) initially had their BP at target, which was increased with intense follow-up and suitable intervention to 47%. The participants with HTN control were more likely to be; of older age, females, practicing active life, nonsmokers, and on single-pill combination therapy with a P value of (0.032, 0.041, 0.043, 0.046, 0.03) respectively. Conclusion: Hypertension control is suboptimal in our population. Intense follow-up and appropriate interventions resulted in better BP control. Older adults, women, nonsmokers, those practicing active life, and those on single-pill combination therapy were more likely to achieve adequate control. Our findings might prompt redesigning the hypertension control program in our region into a more sustainable expandable one.