Objective: Although hypertension is the leading cause of cardiovascular complications, time to develop cardiovascular complications among hypertensive patients has not been adequately investigated in Ethiopia. Therefore, the aim of this study was to assess time to develop cardiovascular complications and its predictors among adult hypertensive patients at the Ayder Comprehensive Specialized Hospital, Ethiopia. Result: A total of 578 hypertensive patients from the Cardiology Department were included in the study and followed for a total of 60 months (median 28 months). Half of the participants (290, 50.2%) were females. The median age of subjects was 54 years. Out of the 578 hypertensive patients who were analysed, 25.4% of them developed a cardiovascular complication. The incidence rate was 8.25 per 1000 persons per month. Significant predictors in the development of cardiovascular complications among hypertensive patients were age [AHR = 1.03 (95% CI=1.016, 1.046)], baseline cardiovascular complications [AHR=3.03 (95% CI=2.009, 4.870)], protein uria [AHR=3.9 (95% CI=1.3, 11.68)], baseline systolic blood pressure [AHR =1.01 (95% CI=1.003, 2.012)], and baseline diastolic blood pres sure [AHR = 1.013 (95% CI=1.005, 2.021)]. JRCD 2019; 4 (4): 96–100