Abstract Objective Hypertension-related illness increases healthcare expenditure and reduces productivity. There is inadequate information about work productivity loss associated with hypertension in Ethiopia. This study was conducted to determine the extent of paid and unpaid worker productivity loss among adult hypertensive patients in Southern Ethiopia. Facility-based descriptive cross-sectional study was conducted by using the valuation of lost productivity (VOLP) tool adapted to the Ethiopian context. The data entry and analysis were done by using Microsoft Excel 2013 and SPSS version 21.0. Key findings A total of 301 adult hypertensive patients on regular follow-up at selected public hospitals were included in this study. One hundred ninety-five patients were females with a mean age of 50.7 ± 7.3 years. Less than one in five 39 (13.0%) of patients achieved their BP control target. Fifty-three (17.7%) of patients reported that hypertension reduced their work performance by 50%. One hundred twenty-five (60.1%) patients reported that they would complete the same work in less time, if they have no health problem. After adjusting for team impact and work substitutability, 3247.4 USD and 1844.81 USD were lost per month from paid and unpaid work. Overall annual work productivity loss was 38 968.4 USD, and the percentage of lost productivity per month was 18.7%. Summary Hypertension reduced the work productivity of adults by one-fifth. Therefore, it is important to devise strategies by involving all relevant stakeholders for preventing hypertension to save this productivity loss. In addition to this, improving the blood pressure control rate could help to reduce associated productivity loss.