Hypertension, or high blood pressure, poses a critical public health challenge in India, affecting over one in four adults, with some studies indicating the prevalence is closer to one in three Indians. Alarmingly, more than 90% of adults living with hypertension are either undiagnosed, untreated, or fail to achieve adequate control of their blood pressure. This widespread lack of awareness, diagnosis, and effective management contributes significantly to the burden of non-communicable diseases (NCDs) in the country, which are estimated to cause between 5 to 6 million deaths annually in India. Hypertension is a primary modifiable risk factor for severe cardiovascular diseases, directly responsible for 57% of stroke deaths and 24% of coronary heart disease deaths in India. It is recognized as the leading risk factor for stroke and a significant contributor to overall disease burden and mortality. The rising prevalence is linked to various risk factors prevalent in the Indian population, including advancing age, high consumption of dietary fat and salt (with average Indian salt intake nearly double the WHO recommended limit), obesity, sedentary lifestyles, alcohol consumption, and tobacco use. Additionally, factors like low awareness and illiteracy contribute to poor health outcomes. In response to this growing crisis, the Indian government, in collaboration with the Indian Council of Medical Research (ICMR) and the World Health Organization (WHO) - India, launched the Indian Hypertension Control Initiative (IHCI) in November 2017. This five-year initiative aims to reduce the hypertension burden by 25% by 2025, leveraging existing primary healthcare systems and standardizing treatment protocols. While efforts like IHCI have shown some improvement in control rates, particularly in southern and western regions, the overall rates remain suboptimal, highlighting the urgent need for intensified interventions, increased public awareness, and improved screening and treatment programs to combat this 'silent killer'.