ObjectiveThe objective of this study was to evaluate the acceptance and uptake of COVID-19 vaccines in rural Bangladesh.DesignThis was a cross-sectional study conducted between June and November 2021.SettingThis study was conducted in rural Bangladesh.ParticipantsPeople older than 18 years of age, not pregnant and no history of surgery for the last 3 months were eligible to participate.Primary and secondary outcomesThe primary outcomes were proportions of COVID-19 vaccine acceptance and roll-out participation among the rural population. The secondary outcome was identification of correlates which contributed to COVID-19 vaccine acceptance and roll-out participation. Χ²tests and multivariable logistic regression analyses were performed to identify relevant correlates such as sociodemographic factors, clinical conditions and COVID-19-related factors.ResultsA total of 1603 participants were enrolled. The overall COVID-19 vaccine acceptance was very high (1521/1601, 95%), and half of the participants received at least one dose of the COVID-19 vaccine. Majority of participants wanted to keep others safe (89%) and agreed to the benefits of COVID-19 vaccines (88%). To fulfil the requirement of online registration for the vaccine at the time, 62% of participants had to visit an internet café and only 31% downloaded the app. Over half (54%) of participants were unaware of countries they knew and trust to produce the COVID-19 vaccine. Increased age, being housewives, underweight and undergraduate education level were associated with vaccine acceptance, while being female, increased age and being overweight/obese were associated with vaccine uptake. Trust in the health department and practical knowledge regarding COVID-19 vaccines were positively associated with both vaccine acceptance and uptake.ConclusionThis study found a very high COVID-19 vaccine acceptance in rural Bangladesh. Policymakers should support interventions aimed at increasing vaccine and general health literacy and ensure ongoing vaccine supply and improvement of infrastructure in rural areas.