The prevalence of cardiovascular disease (CVD) risk factors in “People of Indian Origin” (PIO) is exceedingly high and strong relationships among elevated blood pressure, increased levels of lipoproteins, visceral obesity, physical inactivity and subsequent high occurrence of coronary heart disease, type 2 diabetes mellitus etc., were evident in many studies. Increasing urbanization with effective changes in lifestyles could be attributed to explain this exaggerated rate. The present community based cross-sectional investigation was aimed to identify rural-urban differences in prevalence of risk factors of CVD in the adult Asian Indians. A total of 350 adult (30 years and above) individuals (184 males and 166 females) belong to urban (n = 193, males = 104, and females = 89) and rural (n = 157, males = 80, and females = 77) areas participated in the study. Anthropometric measures, lipids profiles, fasting blood glucose and blood pressure measures were obtained from participants. The mean body mass index (kg/m2) for male and female was 22.37 ± 4.09 and 23.20 ± 4.37, respectively. There existed significant differences for anthropometric, metabolic, and blood pressure variables between rural and urban areas. Habitat (rural vs. urban) had significant impact on central adiposity, lipids, lipoproteins, and blood pressure measures even after adjusted for age and sex. Overall, 84.3% of females had lower HDL level compared with only 20.1% in males. It was also observed that the prevalence of metabolic syndrome was 56.2% in urban females compared with 36.4% in rural females. Effective urbanization and or modernization seem to influence CVD risk factors and warrants intervention as early as adulthood to check this menace. Am. J. Hum. Biol., 2008. © 2008 Wiley-Liss, Inc.