Hypertension screening and early treatment are essential for preventing severe health complications such as stroke, heart failure, and coronary heart disease. Screening allows for the identification of hypertension at an asymptomatic stage, facilitating timely control before irreversible damage occurs. However, in low- and middle-income countries such as Ethiopia, hypertension screening practices are poorly understood and inadequately addressed in national disease prevention strategies.This study aims to examine the barriers and enablers of hypertension screening practices among middle-aged adults in Ethiopia.This study employed a descriptive qualitative research design, conducted between April and May 2025 in Ethiopia. The study used a purposive sampling technique to recruit study participants. Data were collected through in-depth interviews and conducted by an experienced qualitative data collector. The interviews were transcribed verbatim, translated from the local language into English, and inductive thematic analysis was performed using ATLAS.ti software version 7. Finally, the results were presented thematically with thick descriptions.In-depth interviews were conducted with three participants from rural, urban, and semi-urban areas. An inductive thematic analysis revealed three main themes and seven subthemes related to hypertension screening: Theme one, Personal barriers to hypertension screening; theme two, External barriers to hypertension screening; and theme three, Enablers of hypertension screening.This study examines the barriers and facilitators of hypertension screening practices among middle-aged adults. Findings from thematic analysis and interviews are categorized into three main themes and nine categories. The study identified several barriers to hypertension screening, such as cultural beliefs, limited support from health professionals, community-related factors, inadequate health facility services, and individual-level challenges. Conversely, enabling factors included community mobilization, the involvement of community and religious leaders, the presence of role models, facility-based screening programs, awareness initiatives, and accessible diagnostic services.Overall, the findings suggest that barriers to hypertension screening go beyond individual factors. They include community, interpersonal, and health service-related challenges. Addressing these complex barriers necessitates a collaborative effort involving communities, government entities, religious institutions, and non-governmental organizations.