Purpose <p>This paper sought to understand how experiences of various levels of racism across multiple domains and geographical regions were associated with higher odds of hypertension among African American adults by sex.</p> Methods <p>Data were from the African American Identity, Socialization, Discrimination, and Outcomes Project, collected January–February 2020. Participants self-identified as African American/Black individuals, were 18 + years of age, and completed a Qualtrics survey with items measuring perceived experiences of racism and health. Hypertension diagnosis served as the outcome variable. The Experience of Discrimination Questionnaire assessed racist experiences in six areas: personal (insults, slurs), education, employment, housing, law, and police interaction. We conducted bivariate analyses examining the distribution of experiences of discrimination by age, sex, and region using logistic regression to understand how racism patterned by these factors impacted odds of hypertension.</p> Results <p>In our sample (<i>n</i> = 1177), the distribution of racism experiences varied by sex and age. Additionally, reporting job discrimination and having a usual source of care were significantly associated with higher odds of hypertension in the overall sample (OR_Job = 1.44, 95% CI: 1.04–1.99; OR_care = 1.73, 95% CI: 1.26–2.40). Females with a college or graduate degree reported slightly lower odds of hypertension (OR_Edu = 0.52, 95% CI: 0.32–0.89).</p> Discussion <p>People reported experiencing racism in different domains as they aged. Findings indicate sex-based differences in the experiences of racism and its association with hypertension. Our study underscores the importance of understanding which experiences of racism are more salient, for whom, when, and with what impact.</p>