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Objective: To compare the efficacy of telmisartan and atenolol in management of patients with essential hypertension. Study Design: Randomized comparative trial. Place and Duration of Study: Department of Medicine Combined Military Hospital Peshawar, from Feb 2010 to Aug 2010. Material and Methods: One hundred & eighty patients diagnosed with essential hypertension fulfilling the inclusion criteria were included in study using consecutive non-probability sampling after taking informed consent. Patients were allocated to either telmisartan or atenolol group by using a table of random numbers. Follow up of patients was carried out in 4 visits with recording of sitting systolic and diastolic blood pressures. Results: Among total of 180 patients, 60% were females and 40% were males. Majority were between age group 56-75 years. Reduction of both systolic and diastolic blood pressures at the end of eight weeks was significantly greater with telmisartan as compared to atenolol (p-value=0.000 and 0.016 respectively). Conclusion: At the end of eight weeks of treatment, telmisartan was more effective than atenolol in lowering systolic and diastolic blood pressure.