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Introduction Hypertension is a principal risk factor for cardiometabolic multimorbidity (CMM) but evidence regarding the prevalence and management of hypertension among people with CMM is scarce. May Measurement Month (MMM) is the largest annual global campaign collecting data on blood pressure (BP) and other cardiometabolic conditions. This study aimed to understand how hypertension prevalence, treatment, and control vary among combinations of cardiometabolic conditions.Methods In this cross-sectional study, 4 million MMM adult participants (≥18 years) across 105 countries were screened with triplicate BP measurement and information on lifestyle and cardiovascular risk factors. Participants were recruited using opportunistic convenience sampling. CMM was defined as the co-existence of ≥2 of three cardiometabolic conditions: diabetes, myocardial infarction and stroke. Eight subgroups were established for all possible combinations of cardiometabolic conditions.Results This analysis included 3 397 746 participants. Of these, 408 162 had at least one cardiometabolic condition and 91 222 (2.7% of the total cohort) had CMM. Among individuals with CMM, 56.1% had hypertension. As the number of cardiometabolic conditions increased, the percentage of participants with co-existing hypertension increased, along with the percentage of participants on BP-lowering treatment. Despite higher treatment rates in hypertensives with CMM (85.6%) vs those with no cardiometabolic conditions (45.4%), BP control rates (<140/90 mm Hg) were similar to those with no conditions or a single condition. Among subgroups, those with all three conditions were most likely to have co-existing hypertension and take BP-lowering medication.Conclusions The burden of hypertension increases with the number of cardiometabolic conditions and varies across subgroups. Treatment and control rates are suboptimal in those with CMM, and efforts are needed to improve BP control of high-risk populations with diabetes, heart disease or stroke.