Objectives: The primary objective of this study was to evaluate the differences in plasminogen activator inhibitor-1 (PAI-1) serum concentrations between hypertensive patients and healthy controls and to assess the potential impact of obesity on PAI-levels within the hypertensive population. Subjects and methods: This cross-sectional study enrolled two groups, each consisting of 40 participants. One group consisted of patients diagnosed with hypertension, while the other one consisted of age- and sex-matched healthy controls. Serum PAI-1 concentrations were measured in a cohort of patients with arterial hypertension and age- and sex-matched healthy controls. Participants were categorized into obese and non-obese groups based on body mass index, with 30 kg/m2 set as the threshold. Clinical parameters including blood pressure, lipid profile, and anthropometric data were collected. Correlation analysis between PAI-1 levels and various clinical and laboratory parameters was performed using Pearson's correlation coefficient. Results: PAI-1 serum concentrations were significantly higher in patients with arterial hypertension in comparison to healthy age- and sex-matched controls (4327.52 ± 1100.26 pg/mL vs. 2278.35 ± 1046.43 pg/mL, P < 0.001). Furthermore, PAI-1 serum concentrations were significantly higher in obese hypertensive patients when compared to non-obese hypertensive patients (4445.32 ± 1146.36 pg/mL vs. 4173.88 ± 1211.33 pg/mL, P = 0.031). A significant positive correlation was found between PAI-1 levels and diastolic blood pressure (r = 0.314, P = 0.004). No significant correlations were found between PAI-1 and age, BMI, total cholesterol, LDL-C, HDL-C, or triglycerides, indicating that these factors may not directly influence PAI-1 levels in hypertensive patients. Conclusion: Overall, these findings suggest that PAI-1 may be a useful biomarker for cardiovascular risk stratification in hypertensive patients. In addition, observations concerning difference in PAI-1 depending on body mass index highlight the impact of obesity on hypertensive pathology.