Objective: To investigate the utilization and the factors influencing satisfaction of follow-up service among hypertension patients in western rural areas of China, and to provide evidences for strengthening the effect of follow-up management of hypertension in western China. Methods: We used the special survey data of township and village health services integration in the minority areas of western China in 2014. A total of 880 participants were examined with stratified random sampling method in Qinghai agricultural areas, Qinghai pastoral areas, Inner Mongolia and Xinjiang Uygur Autonomous Region. Pearson ?字2 and binary logistic regression were performed to analyze the data. Results: 72.7% of the patients were followed up for more than 4 times a year. 88.3% of the patients had face to face follow-up service. 64.2% of the patients were informed of the next follow-up time. 61% of the patients believed that it is necessary for follow-up regardless of the severity of the disease. These rates were statistically different in the above 4 areas (P < 0.05). The binary logistic regression showed that district, distance from the nearest medical unit, time of follow-up service and whether to be informed of the next follow-up time were influencing factors. Conclusion: Personalized follow-up should be provided in the rural areas of western China, meanwhile, the prevention and control of hypertension and its complications should be strengthened. It is also suggested that we should make innovations in the management of chronic disease and promote hypertension patients to participate in the follow-up.