A damping force adjustable hydraulic shock absorber, in which response delay of a pressure control valve and self-excited vibration of a valve body can be prevented. A damping force is generated by controlling an oil flow between an annular oil passage (21) and a reservoir (4) generated by sliding movement of a piston in a cylinder with use of a back-pressure type main valve (27) and a pressure control valve (28). The damping force is directly generated by the pressure control valve, and valve-opening pressure of the main valve is adjusted by adjusting an inner pressure of a back-pressure chamber. In the pressure control valve, a valve spring is disposed between a valve body and a plunger. A mass of the valve body is sufficiently less than that of the plunger, and a spring stiffness of the valve spring is higher than that of a plunger spring.