Health beliefs influencing compliance and psychosocial adjustment to illness were compared in two groups of hypertensive patients. Based upon clinical judgments of physicians, 15 controlled and 15 uncontrolled hypertensives made up the study group. Subjects came from a white middle to upper class suburban community and were demographically homogeneous. There was no significant difference between groups in health beliefs affecting compliance, but significant differences were found in several domains related to psychosocial adjustment to illness. Uncontrolled hypertensives showed less illness-related adjustment. They reported significantly greater difficulties in their domestic environments, more disturbances in extended family relationships, and more psychological distress. Less adjustment to illness was significantly correlated with less compliance and with a more complex medication regimen. No relationships were found between compliance and demographic variables, medication variables, or duration of hypertension; nor between adjustment, demographic variables, or illness duration. Clinical assessment of illness-related adjustment problems may help enhance compliance of hypertensive patients.