Background: Hypertension and diabetes frequently co-exist, compounding morbidity and mortality, particularly in lowresource settings like Bangladesh. Objective: This study aims to assess the prevalence, risk factors, and clinical outcomes of hypertension-diabetes co-morbidity, evaluating management efficacy in a Bangladeshi tertiary hospital. Method: A crosssectional study was conducted at a Department of Cardiology, Jamalpur Medical College from January 2023 to June 2024, involving 114 patients diagnosed with both hypertension and diabetes. Patient data were obtained through medical records and structured interviews. Statistical analysis included chi-square tests to compare categorical variables, with significance set at p < 0.05. Results: Among 114 patients, 68.4% were male and 31.6% female, with an average age of 57.5 years. Patients over 60 years were significantly more likely to exhibit co-morbid complications (54%, p = 0.03). A high prevalence of obesity (47.3%) and sedentary lifestyle (64%) was noted. Poor glycemic and blood pressure control was prevalent, with only 28% achieving target blood pressure levels (p = 0.04) and 35% within target HbA1c ranges (p = 0.02). Cardiovascular complications were present in 42.1% of patients, while early-stage renal impairment was observed in 21% (p = 0.01). Conclusions: The study demonstrates a significant burden of hypertension-diabetes co-morbidity and supports the need for integrated management strategies to enhance patient outcomes in Bangladesh.