Background <p>Health literacy has been shown to benefit disease management, with patient activation level being important. This study aimed to assess health literacy and activation levels in hypertensive patients, investigating the relationship between literacy and activation.</p> Methods <p>The present descriptive and correlational study was conducted with 425 participants. The study was granted ethical approval by the Health Sciences Ethics Committee of a university, and institutional permission was obtained from the relevant Provincial Health Directorate. The data collection tools employed included the Socio-demographic Data Form, the Patient Activism Measure, and the European Health Literacy Scale short form.The data were collected through in-person interviews conducted in the counselling department of the family health centre.The analysis of the data involved the use of statistical methods, including number, percentage, chi-squared test, and ordinal regression analysis.</p> Results <p>The study revealed that 46.4% of the participants exhibited insufficient health literacy, 19.1% demonstrated problematic health literacy, and 34.5% demonstrated adequate literacy. The findings further delineated that 12.4% of the participants were positioned at level 1, 11.8% at level 2, 39.8% at level 3, and 36.0% at level 4 of patient activation. The findings of this study indicate that individuals with a patient activation level 4 exhibit an adequate health literacy level greater (<i>p</i> = .001) in comparison to individuals with a patient activation level 1.</p> Conclusions <p>The study found a link between patient activism and health literacy among people with hypertension. It is recommended that efforts be made to improve health literacy to strengthen patient activism in managing the condition.</p>