ObjectiveWe implemented this study to report the prevalence and associated risk factors of hypertension among adult men and women aged >30 years residing in selected urban and rural areas of Dhaka division, Bangladesh.DesignCross-sectional study.SettingTwo urban (Dhaka city north and Dhaka city south) and two rural (Narsinghdi and Gazipur district) areas of the Dhaka division.ParticipantsA total of 4856 male and female participants were included in the final analysis, of whom 2340 (48.2%) were from urban and 2516 (51.8%) were from rural areas.Primary outcomeHypertension was the dependent variable for this study and was operationally defined as systolic blood pressure >140 mm of Hg and/or diastolic blood pressure >90 mm of Hg, and/or persons with already diagnosed hypertension.ResultsThe overall prevalence of hypertension was 31.0%, and the prevalence was higher among urban participants (urban: 36.9%, rural: 30.6%). Age (across all categories), female (urban—adjusted OR (AOR): 1.3, 95% CI: 1.0 to 1.5 and rural—AOR: 1.7, 95% CI: 1.4 to 2.1)), higher educational status (urban—AOR: 1.7, 95% CI: 1.3 to 2.2 and rural—AOR: 2.1, 95% CI: 1.5 to 3.1), inadequate physical activity (urban—AOR: 1.3, 95% CI: 1.0 to 1.7 and rural—AOR: 1.5, 95% CI: 1.2 to 1.9) and overweight/obesity (urban—AOR: 2.7, 95% CI: 2.1 to 3.3 and rural—AOR: 2.1, 95% CI: 1.7 to 2.5) were associated with hypertension in both urban and rural areas. Women who were not currently married during the survey had higher odds of hypertension only in the rural areas (rural—AOR: 1.8, 95% CI: 1.3 to 2.4), and respondents who were not working during the survey had higher odds of hypertension only in the urban areas (AOR: 1.7, 95% CI: 1.0 to 2.6).ConclusionSince the prevalence of hypertension was high in urban and rural areas, the government of Bangladesh should consider implementing hypertension prevention programmes focusing young population of Dhaka division. In addition, early screening programmes and management of hypertension need to be strengthened for people with hypertension in both the areas.