Hypertension remains a major global health concern, contributing significantly to cardiovascular morbidity and mortality. In sub-Saharan Africa, it is a leading cause of adult health complications, despite the availability of effective antihypertensive medications. One critical aspect of addressing hypertension management is analyzing prescribing patterns, which help assess and optimize medical treatment to ensure efficiency and cost-effectiveness. Accurate prescribing practices are essential in achieving optimal therapeutic outcomes and improving patient health. This study evaluates the prescribing patterns of antihypertensive medications in a tertiary care hospital in Southern Nigeria, focusing on adherence to the latest guidelines set forth by the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8). The JNC-8 guidelines provide evidence-based recommendations that include updated therapeutic goals, treatment thresholds, and preferred drug regimens, with an emphasis on patient-specific factors. This review of antihypertensive prescribing practices aims to determine whether current clinical practices in the region align with these guidelines and identify potential gaps in treatment that may impact patient outcomes. The study also explores the challenges faced by healthcare providers in adhering to these guidelines, particularly within resource-constrained settings like Southern Nigeria. By assessing prescribing practices and comparing them with established JNC-8 recommendations, the study seeks to contribute to the improvement of hypertension management and ultimately reduce the burden of hypertension-related complications in the region.