Abstract: Objective To investigate the prevalence of hypertension and its association with family history (FH) in Han people aged 20-80 living in Gansu Province. Methods By performing a multi-stage stratified clustering sampling method, 4 247 Han people resident in four sites in Gansu Province were selected as study participants. All participants underwent face to face questionnaire interview, physical examination and biochemical tests. Results A total of 4 247 Han subjects aged 20-80 years were included, among which 1 777 (41.8%) were men and 2 470 (58.2%) were women. The response rate and the eligibility rate were 97.4% and 98.7%, respectively. The crude prevalence of hypertension was 28.2%. Along with elevated FH categories, participants had increased prevalence of hypertension. The multi-variable logistic regression analysis indicated that after adjusting for age, sex, current residential area, body mass index (BMI), educational level, tobacco use, alcohol consumption, physical activity and diabetes, participants with FH had 3.36 times higher (OR=3.36,95% CI:2.58-4.41,P<0.001) than those without FH of hypertension. The risk of hypertension also increased with the number of affected generations(one:OR=2.33, 95% CI:1.77-3.09, P<0.001; two:OR=5.97, 95% CI:4.42-8.13, P<0.001; three:OR=14.64, 95% CI:8.30-26.27, P<0.001). Conclusions The prevalence of hypertension is higher in people with hypertension family history. As FH categories increase, a consistent trend of increasing hypertension prevalence is observed. Since individual with FH of hypertension can be easily identified, screening and targeted intervention toward this population may improve the prevention of hypertension.