Background: Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Lack of knowledge about hypertension is a major challenge in controlling hypertension. To reduce this burden, patients have to be aware of lifestyle changes and take measures regarding self-care. Pharmaceutical care is founded on the caregiver's responsibility to address all patient's drug-related needs to achieve measurable outcomes that improve the patient's quality of life. Methods: A systematic review was performed using MEDLINE, EMBASE, Scopus, and LILACS databases for articles published from January 2000 (year of PC to July 2022, for randomized controlled trials that involved pharmacist care interventions among outpatients with hypertension. Reviewers independently abstracted data and classified pharmacists’ interventions based on mean changes in blood pressure. Results: The studies analyzed in terms of practice settings, 11 (73%) of the studies were conducted in community pharmacy and 4 (27%) were in clinics. The sample size ranged from a minimum of 24 patients and a maximum of 567. Drug therapy follow-up ranged from 2 to 10 months. In 8 (53.33%) of the articles, the age range of the sample was 18 to 60 years. The interventions exclusively delivered by pharmacist education and counseling about medications, lifestyle or compliance; distribution or use of educational material; patient educational workshop, patient interview; assessment of medication compliance; monitoring of medication therapy such as assessment, adjustment, or change of medications defined as drug-related problems (DRPs) identification. Pharmaceutical care and Usual pharmacy dispensing services were both associated with statistical reductions in systolic and diastolic BP, but no major differences were demonstrated between standard care and pharmaceutical care. In case, the weighted mean difference in systolic BP, −9.1mmHg [95% CI, −29.4 to −2.9]; the weighted mean difference in diastolic BP, −5.1 mm Hg [95% CI, −7.0 to −3.1]; and control, weighted mean difference in systolic BP, −6.8mmHg [95% CI, −21.6 to −1.4]; and weighted mean difference in diastolic BP, −2.2 mm Hg [95% CI, −4.6 to −0.2]). Moreover, there was a positive impact of pharmaceutical care. Conclusion: Patients who received pharmaceutical care had controlled blood pressure as compared to the group of patients using standard pharmaceutical services. Pharmaceutical care also had a positive effect on controlling blood pressure and cardiovascular risk.