Background: Health literacy data is critical for enhancing self-care abilities and improving healthcare outcomes. However, information on health literacy level in rural Bayelsa, Nigeria’s Niger Delta region, is dearth. Objective of the study was to determine health literacy level of rural dwellers utilizing the services of Primary Healthcare Centers in rural Bayelsa.Methods: A total of 800 participants were randomly selected through multistage sampling procedure in a cross-sectional survey. Demographic data assessment questionnaire and the Brief Health Literacy Screening Tool were used for data collection. Descriptive statistics was done to obtain summaries of demographic and health literacy data while independent samples t-test, and one-way between group analysis of covariance was conducted to determine area-based differences in health literacy scores and the impact of frequency of health center visit on participants’ health literacy scores, respectively.Results: Health literacy assessment showed that, 570 (71.25%) participants had limited health literacy; 142 (17.75%) had marginal health literacy, and 88 (11.00%) had adequate health literacy. Health literacy scores were significantly higher in the upland (M=22.08, SD=8.64), than riverine areas of rural Bayelsa (M=18.66, SD=8.46; t (800)=8.02, p=0.00, 2-tailed). Frequency of health center visit significantly accounted for 20% of the variance in participants’ health literacy scores (F (2, 796) = 95.72, p=0.00, eta squared=0.20)).Conclusions: Health literacy level is low, and indicates a public health emergency. Rural educational development and modification of rural healthcare communication pattern may reduce health illiteracy and its attendant effect.