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Objectives. To check for the association of genetic polymorphisms related to the methylenetetrahydrofolate reductase (MTHFR) gene namely C677T and A1298C with hypertension in Saudi affected subjects from Qassim region. Subjects and methods: Participants included 123 Saudi hypertensive cases (83 males and 40 females) in addition to 250 (142 males and 108 females) unrelated healthy controls from the same locality. Their age mean ±SD was 50.93 ± 15.43 years. For all subjects, DNA was extracted followed by real-time PCR amplifications for characterization of genotypes and alleles related to MTHFR C677T and A1298C gene polymorphisms Results: Total cases showed significantly higher carriage rate for the mutant allele 677T compared to controls (40.7 % vs. 26%, OR=1.9, 95 % CI = 1.2-3.1) with a lower frequency of the wild type 677CC genotype (59.3 % vs. 74%, p=0.004). The same was observed among cases-subgroups of hypertension associated with obesity with a notably higher odds ratio (OR=2.6, 95% CI=1.3-5.01, p=0.004). Total cases showed also significantly higher frequency of mutant 1298 C allele carriage rate compared to controls (59.3 % vs. 42.4%, OR=1.98, 95 % CI = 1.3-3.1) with a lower frequency of the normal AA genotype (40.7 % vs. 57.6%, p=0.003). The same was observed among cases-subgroups of hypertension associated with both diabetes and obesity and among cases of hypertension with obesity, also with higher odds ratio (OR=2.6 and 2.2 respectively). Conclusion. This work showed that genetic polymorphisms related to the MTHFR gene are associated with the risk o