Hypertension is the global disease burden and not only a major risk factor for stroke, but is also crucial risk factor for cognitive impairment and subsequently dementia. However, literature highlighting on cognitive functions is scarce in Malaysia. This study aimed to assess the hypertension and cognitive functions among the Rungus population in rural areas of Kudat, Sabah. A community based cross-sectional study was conducted among population aged 18 and above living in two villages of Kudat. A validated Malay version of Mini-Mental State Examination (M-MMSE) was used to assess cognitive function with cut-off point of 22. Socio-demographic data, risk behaviours (e.g. physical activity level, smoking status and alcohol consumption) and clinical characteristics (e.g. blood pressure, body mass index and waist circumference) were collected. Chi-square and regression model were used for data analysis. A total of 183 respondents participated in this study with a mean age of 44.64 ± 17.26. The prevalence of hypertension was 34.97% and mean score of MMSE was 24.19 ± 5.660. Age, education level, body mass index and waist circumference were significantly associated with hypertension. Hypertension was not significantly associated with cognitive impairment but instead significantly associated with lower performance of MMSE and its language domain. Therefore, comprehensive interventions should be emphasized to have better understandings on hypertension and prevent its damage to cognition.