Background: Obesity and arterial hypertension (AHT) are both significant cardiovascular risk factors, with obesity being a major contributor to the development of AHT. AHT in obese patients is particularly challenging to control due to the increased risk of target organ damage. Obesity has been identified as an independent predictor of uncontrolled AHT in Tunisian patients, as demonstrated by the national multicentric study on AHT (NATURE HTN). Therefore, we aimed to examine the profile of AHT in obese Tunisian adults recruited from the Tunisian registry NATURE HTN. Methods: A total of 23601 hypertensive individuals were recruited from the national multicentric registry NATURE HTN. Participants were divided into groups based on whether they had controlled or uncontrolled AHT defined as an average of systolic blood pressure above 140 mmHg or an average of systolic blood pressure above 90mmHg AHT according to their body mass index (BMI). Results: The profile of AHT in obese Tunisian adults was as follow: female predominance (69.47%), half was diabetic, 74.67% have a low educational level; renal and cardiac impact were present (24.82% of microalbuminuria, 14.47% of left ventricular hypertrophy on transthoracic echocardiography), and 15% were untreated. This profile classifies our population at high cardiovascular risk although. There is a linear association between severity of obesity and uncontrolled blood pressure (BP). In the subgroup of severe obesity, mellitus diabetes and heart rate were associated with uncontrolled AHT [odds-ratio and confidence interval: 1.09 [1.06-1.12]; 1.11 [1.07-1.15], respectively]. In multivariate analysis, diastolic blood pressure (DBP) and Heart rate (HR) were independently associated with obesity. Conclusion: There was a strong association between severity of obesity and uncontrolled BP CF and DBP were independently associated with obesity. obese and hypertensive patients were also diabetic and had organ damage. Therefore, an urgent and targeted treatment strategy is necessary.