Objective  To explore the relationship between smoking and hypertension among middle-aged and elderly residents in Ma'anshan city, Anhui Province, and provide theoretical basis of hypertension prevention and treatment.  Methods  According to the multi-stage sampling method, 12 132 residents were selected from August to November 2020 in three districts of Ma'anshan city, and participated in questionnaire survey and physical measurement. Binary logistic regression was used to analyze the association between smoking and hypertension, and the dose-response relationship for smoking and hypertension was analyzed using the restricted cubic spline (RCS) model and the generalize linear model.  Results  There were 11 457 subjects in this study, including 6 067 patients with hypertension(52.95%). Taking non-smokers as the reference, the OR value of the risk of hypertension in former smokers was 1.37(95% CI: 1.20-1.56), 1.25(95% CI: 1.07-1.46) and 1.18(95% CI: 1.00-1.39) in Model 1, Model 2 and Model 3, respectively. The RCS curve of smoking and hypertension presents an approximate "J" shape. When the smoking index was greater than 25 pack-years, the risk of hypertension increased monotonically with the increase of smoking index, and the subgroup analysis showed the same results. P_non-linear was greater than 0.05 and P_total was less than 0.001, indicating a linear dose-response relationship between smoking and hypertension. The results of the generalize linear model showed that for every 1-pack-year increased in the smoking index, the risk of hypertension increased 1.004-fold.  Conclusion  There is a significant dose-response relationship between smoking and hypertension in middle-aged and elderly people.