The objective of the study is to assess the perception and practice of hypertensive patients and impact of patient counselling on lifestyle modifications in management of hypertension, among rural populations of Salem district. The prospective study was conducted in Hypertensive patients residing at Kondapanaickenpatty village of Salem district for a period of six months. The data was collected from the Hypertensive patients including their demographic details, using standard questionnaires and then the patient counseling was provided with the aid of pamphlet prepared in their local language and then after a period of 1 month time interval, patient's awareness and practice were reassessed using the questionnaires and Blood pressure values. Out of 100 patients, 47% comprised of male patients and 53% were female patients. The body mass index of study population revealed that majority of the patient was overweight (44%) and only 21% of patients have normal BMI. 28% of the patients was obese. This result indicates the inadequate practice of lifestyle modification among the patients. At the beginning of the study the mean systolic blood pressure and mean diastolic blood pressure of the study population was found to be 141.3 mmHg and 88.9 mmHg respectively. At the end of the study the mean blood pressure level was controlled. Mean systolic blood pressure was reduced by 2.6 mmHg (138.7 mmHg) and Mean diastolic blood pressure was reduced by 2.4 mmHg (86.5 mmHg). This results indicates effective counselling about the disease and proper education on the role of lifestyle modification in management of the hypertension, will help in the effective control of blood pressure within the normal ranges, thus the quality of life among the hypertensive patients in these rural areas could be improved.