The incidence of skin cancer is increasing because of the aging population and ultraviolet exposure, and previous studies revealed that long-term use of hydrochlorothiazide (HCTZ), one of the antihypertensive agents, has been associated with an increased risk of non-melanoma skin cancer (NMSC). However, that within the Asian population is not well known.we investigated the risk of NMSC in Korean subjects with HCTZ use.A retrospective cohort study of 62,243 subjects exposed to HCTZ with a cumulative dose of ≥2,500 mg and 62,243 1:1 age-, sex- and income level-matched unexposed subjects was conducted using the administrative healthcare data.There was significant difference in cumulative incidence of NMSC between the two groups (log-rank p-value=0.033). When the Cox regression analysis after adjusting for potential confounders was conducted, the risk for NMSC in the group exposed to HCTZ was significantly higher when compared with the unexposed group (HR 1.48; 95% CI 1.03-2.13). In the subgroup analysis, the oldest age group (≥ 70 years) showed increased cumulative incidence of NMSC with statistical significance when compared to the non-exposed (log-rank p-value=0.008).In this study, we revealed that the cumulative use of HCTZ (≥ 2500 mg) could increase the risk of NMSC in Koreans, especially the older age group. Thus, HCTZ could be a risk factor for NMSC not only in Caucasians but also in Asians.