Objective To investigate the correlation between exercise decision balance and personality traits in patients with essential hypertension. Methods A total of 198 patients with essential hypertension were selected, and investigated by using a general data questionnaire, the Decision Balance Scale and Eysenck Personality Questionnaire. Results In these patients, the score of exercise benefit was 2.85 (2.15,3.46) points, the score of exercise cost was 2.83 (2.00,3.67) points, the score of exercise decision balance was 0.24 (-0.82,0.82) points, and the patients with a score of less than 0 accounted for 42.35%.Balance of exercise decision was negatively correlated with psychoticism and neuroticism in personality traits,meanwhile it was positively correlated with extroversion/introversion (all P＜0.05).Gender, marital status and educational levels were key influencing factors of exercise decision balance. Furthermore, personality traits were important predictors of patients′ exercise decision balance (all P＜0.01). Conclusion The level of exercise decision balance in patients with essential hypertension is relatively low, which is closely related to personality traits.On the basis of fully evaluating physical and psychological characteristics of patients, nurses should carry out targeted health education and nursing intervention, and instruct the patients to manage their emotions correctly, and to make a reasonable exercise plan, so as to improve recovery from the disease.