The significantly decreased availability of the main raw materials for making shrimp paste is a big problem, while most by-products from shrimp processing, especially head, are not yet properly used. Therefore, using shrimp head for shrimp paste production is well motivated. However, traditional shrimp paste is high in salt and can impact health via hypertension, kidney, or cardiovascular disease. This study aimed to produce a reduced sodium shrimp head paste, using 12, 14 or 16-fold amount of shrimp heads relative to salt. The salted shrimp head was fermented for 14-16 hr. Thereafter, it was dried at 60 °C, then ground and fermented further for 30 d. The paste was dried again to 40-45% moisture content and fermented for another 90 d. The total viable count and lactic acid bacteria significantly decreased in all treatments, and no pathogenic microorganisms were detected. After fermentation for 90 d, the a w had decreased in all treatments. The highest shrimp head proportion (16:1) exhibited the highest total volatile basic nitrogen (TVB-N) and trimethylamine (TMA) contents. In conclusion, shrimp head can serve as an alternative raw material in shrimp paste with comparatively low salt content that may reduce the risks of hypertension, cardiovascular disease, and stroke.