Objectives: The aim of this study was to investigate the association between skill underutilization, a psychological job stressor proposed in the NIOSH (National Institute for Occupational Safety and Health) job stress model, and the prevalence of hypertension. Methods: We studied sitting blood pressure and fasting blood laboratory parameters in 3,429 inhabitants of the town of Watari during annual health check-ups in 2010. A questionnaire was administered to examine job status, weekly working hours and degree of skill utilization. We divided subjects into tertiles according to skill utilization score. Multivariate logistic regression analysis was performed using prevalent hypertension as the dependent variable. Results: Questionnaires were collected from 2,550 individuals. After excluding those who were not in paid employment and those with missing data, 1,075 permanent or part-time workers were included in the final analysis. The odds ratio for the presence of hypertension was significantly higher in the lowest tertile of skill utilization score compared with the highest tertile (1.776; 95% confidence interval, 1.137–2.796) after adjusting for age, sex, body mass index, low-density lipoprotein cholesterol level, triglyceride level, current smoking status and daily alcohol intake. Conclusions: Skill underutilization was associated with a higher prevalence of hypertension in a working population including various kinds of occupations.(J Occup Health 2014; 56: 225-228)