Data on the prevalence and predictors of hypertension in Kinmen, an island very close to southern mainland China but under Republic of China administration, would be very helpful to understand the effect of environmental and psychosocial factors on hypertension in a specific ethnic group. In 1991, Kin-Hu residents ≥ 30 years of age, living in the second largest township of Kinmen, were invited to participate in this survey incorporating face-to-face interviews with a structured questionnaire, collection of fasting blood samples and oral glucose tolerance test. The response rate for subjects with complete data was 80.3% (3289 of 4097). The prevalence rates for definite hypertension (≥160/95 mm Hg and/or under antihypertensive treatment) were 20.1, 14.0, and 16.9% for men, women, and the total population, respectively. Overall awareness, treatment, and control rates of definite hypertension were 46.9, 25.0, and 4.7%, respectively. According to the final logistic regression model, after controlling for all other covariates, the significant predictors for current-definite hypertension were old age, male sex, nonsmoking, obesity, alcohol intake, high waist-to-hip ratio, high serum triglyceride and high serum uric acid levels. In comparison with Chinese in Taiwan and mainland China, the unexpectedly high prevalence of hypertension and distinct set of its predictors in Kin-Hu form the basis for future study.