INTRODUCTION: Non-communicable diseases (NCDs) represent a major public health challenge in Jamaica, particularly within rural communities where socioeconomic and infrastructural barriers may heighten risk. This study examined the prevalence and determinants of hypertension, diabetes, and obesity among 1185 rural adults aged 15 years and older using secondary data from the Jamaica Health and Lifestyle Survey III (2016-2017). METHODS: Descriptive statistics, bivariate analyses, and multivariate logistic regression were employed. RESULTS: Hypertension prevalence was 34.5%, obesity 28.9%, and diabetes 12.8%. Older age was the strongest predictor of disease: adults aged 60 years or more had significantly higher odds of hypertension (odds ratio (OR) 4.8; 95% confidence interval (CI): 3.7-6.2) and diabetes (OR 3.5; 95%CI: 2.5-4.9). Obesity and physical inactivity independently increased risk, while secondary or higher education was protective against diabetes. Women were significantly more likely to be obese. CONCLUSION: The findings highlight the multifactorial drivers of rural NCD burden and underscore the need for targeted, multisectoral interventions addressing behavioural and social determinants of health.