Background: Triglyceride- glucose (TyG) index, a marker of insulin resistance, has been shown to be associated with the incidence of cardiometabolic diseases including hypertension. However, the prognostic role of TyG index is unknown. Hence, we aim to determine the association of TyG index with major adverse cardiovascular events (MACE) in hypertensive patients. Methods: Systematic searching was conducted on 3 databases up till November 2024. We included studies with hypertensive patients despite their comorbidities. Outcome measured is MACE and its individual components. Random effect model meta-analysis is done to pool the results with similar reference point. Results: Twenty observational studies with a total of 451,455 patients of 40 – 70 years old are included. Meta-analysis result shows that higher TyG index is associated with a statistically significant increased risk of MACE (HR 1.90, CI: 1.41 – 2.57, I2 88 %), myocardial infarction (HR 1.55, CI: 1.27 – 1.88, I2 0 %), stroke (HR 1.84, CI: 1.41 – 2.39, I2 62 %), all- cause mortality (HR 1.86, CI: 1.70 – 2.03, I2 0 %) and cardiovascular mortality (HR 1.08, CI: 1.04 – 1.11, I2 0 %). Subgroups of older and younger population, male and female gender, diabetic and non- diabetic population, and higher BMI patients retains the statistically significant risk of MACE (p < 0.05). U- shaped phenomena of TyG index is also demonstrated with the risk of all- cause mortality. Conclusion: TyG index is a reliable prognostic marker of MACE in hypertensive patients and can be utilized in population despite their age, diabetic status, and gender. © 2025 The Author(s)