Pharmacovigilance is well defined by an internationally accepted health organization i.e. WHO, it is a study about finding, evaluation, understanding and avoidance of adverse effects or any other possible drug-related problems. The study of Adverse drug reactions (ADRs) have a major role in regulatory processes of each medicine and ultimately impact on patients lives. Moreover it is an integral part between the patient and health care for better management of disease. Hypertension is one among the several chronic illnesses which is now the principal foundation of cardiovascular diseases worldwide. However, if remains uncontrolled, it can lead to various life threatening complications. The objectives of the study are to evaluate the prescribing trend of antihypertensive therapy among all three hospitals of Hyderabad, to assess the occurrence of ADRs due to antihypertensive drugs in Hyderabad city, to identify the most common adverse drug reactions of different classes of antihypertensive drugs, to assess the knowledge/awareness of patients regarding hypertension and appropriate use of antihypertensive drugs, to compare the ADRs between the hospitals of Hyderabad, to compare the Patient awareness between the hospitals of Hyderabad and to assess the perception of health care professionals regarding Pharmacovigilance. A descriptive cross-sectional study was conducted to evaluate the ADRs associated with antihypertensive therapy and patient’s awareness by collecting the patient’s feedback and health care professionals feedback via purposive and random sampling respectively from medicine and cardiac outpatient departments (OPD) of three major hospitals of Hyderabad, Sindh on predesigned questionnaire based on WHO monitoring guidelines for a period of three years and then data has been evaluated. Out of 3000 patients, maximum numbers of patients were enrolled from GTCH and the percentage was 42.37%. Majority of the patients were belonged to male gender with 57.33%. Further it was also observed that most of the patients were from urban areas with 79.77%. There were two out-patient departments (OPD) from where the patients enrolled i.e. medical as well as cardiac, 64.07% of the patients were reported from cardiac OPD and 35.93% from medical OPD. 30.63% of the patients were aged between 49 to 58 years i.e. maximum. About family history, 20.97% of the patients had positive history as 1 parent, 10.07% of the patients had two parents history while 55.23% of the patients had no any history of hypertension. The maximum number of patients was on combinations therapy i.e. 64.6% as compared to monotherapy patients i.e. 35.4%. Among combinations therapy the dual therapy was most commonly prescribed and the percentage was 65.02% as compared to triple (21.41%) and quadruple therapy (13.57%). In Government tertiary care hospital the most common prescribed antihypertensive drug as monotherapy was Atenolol and the percentage was 16.33%. In Private tertiary care hospital the most common prescribed antihypertensive drug as monotherapy was Telmisartan and the percentage was 15.84%. In Government secondary care hospital the most common prescribed antihypertensive drug as monotherapy was Atenolol and the percentage was 12.24%. In Government tertiary care hospital the most common prescribed antihypertensive drug as dual therapy was Telmisartan + hydrochlorothiazide and the percentage was 14.76%. In Private tertiary care hospital the most common prescribed antihypertensive drug as dual therapy was Valsartan+Amlodipine and the percentage was 13.21%. In Government secondary care hospital the most common prescribed antihypertensive drug as dual therapy was Lisinopril+hydrochlorothiazide and the percentage was 10.66%. In Government tertiary care hospital the most common prescribed antihypertensive drug as triple therapy was Atenolol + Chlorthalidone + Telmisartan and the percentage was 15.30%. In Private tertiary care hospital the most common prescribed antihypertensive drug as triple therapy was Enalapril + hydrochlorothiazide+Atenolol and the percentage was 21.48%. In Government secondary care hospital the most common prescribed antihypertensive drug as triple therapy was Valsartan+ hydrochlorothiazide+Amlodipine and the percentage was 18.56%. In Government tertiary care hospital the most common prescribed antihypertensive drug as quadruple therapy was Atenolol + Chlorthalidone + Telmisartan+αMD and the percentage was 26.44%.In Private tertiary care hospital the most common prescribed antihypertensive drug as quadruple therapy was Valsartan + Amlodipine+Atenolol+Chlorthalidone and the percentage was 35.29%. In Government secondary care hospital the most common prescribed antihypertensive drug as quadruple therapy was Amlodipine+Telmisartan+ Enalapril + hydrochlorothiazide and the percentage was 25.93%.