BACKGROUND: Hypertension is one of the most common chronic diseases. Hypertensive patients who intend to control blood pressure need professional medical assistance. Auricular acupressure is a patient-dependent task, wherein a person does not have to rely on a healthcare professional to self-perform the task. OBJECTIVE: To evaluate the effects of auricular acupressure on heart rate variability (HRV) and quality of life (QoL) in patients with hypertension. METHODS: A randomized controlled trial with permuted block randomization was used. In total, 150 participants from a medical teaching hospital were randomly assigned to the experimental group that received auricular acupressure for 10 weeks, and the control group that received only routine care of equal duration. Outcomes were assessed through HRV parameters, heart rate, blood pressure, and QoL before and after the auricular acupressure intervention. RESULTS: After the adjustment of disease duration and mental health, a significant difference existed between the two groups in body pain (p=.03) and mental health (p=.002) of QoL, but not in HRV parameters, heart rate, blood pressure, and overall QoL (p>.05). CONCLUSION: Acupressure can be applied at the acupoints of shenmen, sympathesis, kidney, liver, heart, and subcortex to improve physical pain and mental health of QoL for hypertensive patients. Auricular acupressure is acceptable and feasible although it does not support physiological benefits. Further studies are warranted to assure the effects of using auricular acupressure as an adjunctive care for patients with hypertension.