Objectives: This study was performed to find the differences in physical activity according to general characteristics and factors related to physical activity between the elderly over 65 with hypertension living rural and urban areas. Methods: This study included 681 participants (221 rural, 460 urban) with hypertension from The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). The collected data were analyzed through an x²-test to examine the differences in physical activity and multiple logistic regression to assess factors related to physical activity between the elderly over 65 with hypertension living rural and urban areas. Results: The significant statistical factors related with physical activities for the urban hypertension group were education level, activities of daily living, and quality of life. However, the related factors for rural residents were activities of daily living and limitation of activity. Conclusions: The study results indicated that the factors that affected the level of physical activity revealed difference in case hypertension between the urban and rural groups. An awareness of the importance of physical activity will have a positive influence on improving the physical function and quality of life for elderly people with hypertension.