This is a prospective case control study. One hundred and thirty Eight (138) consecutive newly diagnosed adult Nigerian hypertensive patients with age- and sex- matched controls were studied. Their basic demographic, clinical and biochemical data as well as urinary sediment findings were compared. Urinary sediment’s element that has significant difference between the two groups was correlated with some variables. The mean age of the patients and controls were 43.21 ± 9.64years and 43.19 ± 9.55years respectively while their mean arterial pressure were 114 ± 14.21mmHg and 90.55 ± 6.65mmHg respectively. The pattern of urinary sediment in order of occurrence were: microscopic haematuria(34.8%), epithelial cells (20%), leucocyturia (7.2%), crystals (6.5%), hyaline casts (5.8%) and granular casts (1.4%). Only microhaematuria was significantly higher in the patients than the controls. The prevalence of abnormal urinary sediment among the patients was 15.2% and is essentially microhaematuria. This correlated positively and significantly with systolic blood pressure, dipstick haematuria and proteinuria. Ten out of twenty one (47.6%) patients with abnormal urinary sediment were not detected by dipstick urinalysis. i