Background: This study compared the risk of hypertension between indigenous and Han adults with type 2 diabetes mellitus (T2DM) in Taiwan. Methods: The data of 89 857 (747 indigenous and 89 110 Han people) T2DM patients aged >= 18 years were extracted from an established cohort of 93 484 diabetic patients using the National Health Insurance system of Taiwan. The prevalence of hypertension before diabetes diagnosis and at the time of survey, and the incidence of hypertension after diabetes diagnosis were compared between the two ethnicities. Results: The indigenous people had a higher prevalence of hypertension before diabetes diagnosis (39.0% versus 29.4%, P < 0.001) and at the time of survey (66.9% versus 54.4%, P < 0.001); and showed poorer blood pressure control, with systolic pressure >= 140 mmHg (38.4% versus 30.3%, P < 0.001) and diastolic pressure >= 90 mmHg (20.4% versus 15.5%, P < 0.001). Logistic and Cox's regression models showed an adjusted risk of hypertension of about twofold in indigenous people compared to the Han people. Conclusions: The indigenous diabetics are more prone to develop hypertension than their Han counterparts in Taiwan.