Background: Hypertension requires continuous medication use and effective self-management, yet treatment adherence often declines because the condition is usually asymptomatic, therapy is prolonged, and patients receive insufficient medication information. Pharmacists can address these barriers through individualised counselling integrated with pharmaceutical care. Research Objective: This study evaluated the effectiveness of pharmacist-led counselling in improving medication adherence and hypertension self-management. Methods: A quasi-experimental pretest–posttest study with a control group was conducted at the Pharmacy Unit of Universitas Indonesia Timur Hospital, Makassar, in January 2026. Twenty adults with hypertension were recruited consecutively and allocated to intervention and control groups, with ten participants each. The intervention group received structured individual pharmacist counselling, while the control group received routine pharmacy services. Medication adherence and self-management were measured using validated questionnaires. Data were analysed using descriptive statistics, paired tests, and between-group comparisons at α=0.05. Results: Medication adherence increased from 57.8 to 78.6 in the intervention group and from 59.0 to 62.8 in the control group. The estimated between-group effect was 17.0 points (95% CI: 8.1–25.9; p=0.001). Self-management increased from 60.9 to 79.2 after counselling, producing a between-group effect of 15.6 points (95% CI: 7.4–23.8; p=0.001). Systolic blood pressure decreased by 13.6 mmHg in the intervention group compared with 3.9 mmHg in controls. Conclusion: Pharmacist-led counselling improved adherence, self-management, and blood-pressure outcomes. Integrating structured counselling into routine pharmacy services may strengthen multidisciplinary hypertension management; however, larger controlled studies with longer follow-up are required.