Abstract: Objective To investigate the prevalence of somatic symptom disorders (SSD) and influencing factors in hospitalized hypertensive patients. Methods A cross-sectional study was conducted. A total of 5 782 patients who were continuously admitted to the Affiliated Cardiovascular Hospital of Qingdao University from January 2022 to May 2023 were recruited. The clinical data were collected. The Somatic Self-rating Scale (SSS), Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the mental health status. The admission diagnosis of patients mainly included hypertension, coronary heart disease, arrhythmia, heart failure, diabetes, and myocardial infarction. The patients were divided into hypertension group (3 256 cases) and non-hypertension group (2 526 cases), and SSD levels were compared between the two groups. The hypertensive patients were further divided into SSD group (1 011 patients) and non-SSD group (2 245 patients) according to the results of SSS scale, and logistic regression was used to analyze the factors affecting SSD in hospitalized hypertensive patients. Results The SSD level in the hypertension group was higher than that in the non-hypertension group 27(23, 31) vs 26(23, 31) points, Z=-2.10, P=0.04. Among hospitalized hypertensive patients, the prevalence of SSD was 31.1% (1 011/3 256), the prevalence of mild SSD was 23.0% (748/3 256), the prevalence of moderate SSD was 7.3% (238/3 256), the prevalence of severe SSD was 0.8% (25/3 256), the prevalence of SSD with anxiety was 9.7% (316/3 256), the prevalence of SSD with depression was 12.7% (414/3 256), and the prevalence of SSD combined with anxiety and depression was 8.0% (260/3 256). Spearman correlation analysis showed that SSD was positively correlated with anxiety (r_s=0.573, P<0.01) and depression (r_s=0.659, P<0.01). Multivariate logistic regression analysis showed that anxiety (OR=4.118, 95% CI 2.981-5.688), depression (OR=11.561, 95% CI 8.655-15.443), female (OR=1.380, 95% CI 1.145-1.663), and aged 60 years or older (OR=1.357, 95% CI 1.113-1.654) were risk factors for SSD in hospitalized patients with hypertension. Conclusions The prevalence of SSD is high in hospitalized patients with hypertension, and it is often complicated with anxiety and depression. The presence of anxiety, depression, female, and aged 60 years or older are influencing factors for SSD in hospitalized patients with hypertension.