Background: Hypertension is a major health problem among people 60 years and older living in low- and middle-income countries. However, the evidence that systematically evaluates the effectiveness of self-management interventions for older people with hypertension is limited. Aim: To synthesise the evidence on the effectiveness of self-management interventions of hypertension among adults 60 years and older in low- and middle-income countries. Methods: Electronic databases, which include CINAHL complete, Ovid Embase, Ovid Medline and Scopus were searched for studies published from January 2010 to December 2024. Outcomes were systolic blood pressure, diastolic blood pressure, medication adherence, enablers and barriers to self-management. Results: From 3615 studies, 18 were included. There was moderate quality evidence that self-management interventions improved diastolic blood pressure compared to usual care (MD = -1.32 mmHg; 95% CI: -2.21 to -0.44). However, there was no significant difference in overall effect in systolic blood pressure (MD = -2.46 mmHg; 95% CI: -5.45 to 0.53) and medication adherence (SMD of 2.76; 95% CI: -1.30 to 6.83). Two enablers of self-management were identified: support for hypertension management and appropriate clinical services. Three barriers were highlighted: physiological and psychological challenges, misconceptions about hypertension and its management, and limited support for self-care. Conclusion: Self-management interventions may improve diastolic blood pressure with a moderate level of certainty in the evidence. In contrast, evidence rated as low to very low certainty suggests that self-management interventions may not improve systolic blood pressure or medication adherence.