Background: Estimating prevalence and identifying risk factors of hypertension are paramount important to develop strategies to prevent hypertensive disease. Although, hypertension is a major public health problem in Ethiopia, there is scarcity of evidence in rural areas of the country. Hence, this study is aimed to assess the prevalence and risk factors of hypertension among adult population in rural districts of northwest Ethiopia.Methods: Community based cross sectional study was conducted from June to October, 2020. Multistage cluster sampling technique was used to select 1177 study participants. A face to face interview was conducted using an adapted version of the WHO STEPwise approach questionnaire. The blood pressure was measured three times using aneroid sphygmomanometer and the mean of the last two readings were used for the analysis. Data were entered using Epidata and analyzed using STAT-14. Multivariable logistic regression was used to identify risk factors associated with hypertension.Results: Of the total participants, 218(18.5%) were found to be hypertensive. The prevalence of hypertension consistently increased with age. Hypertension was positively and significantly associated with female sex ((adjusted odd ratio (AOR)=2.30, 95% CI: 1.53, 3.45)), age group 45-54 years (AOR=4.63, 95% CI: 1.01, 21.37), 55-64 years (AOR=14.40, 95% CI: 3.07, 67.63), ³65 years (AOR=19.37, 95% CI: 4.03, 93.09), having history of alcohol consumption (AOR=3.25, 95% CI: 1.17, 9.02), used much amount of salt (AOR=2.37, 95% CI: 1.53, 3.60), used too much amount of salt (AOR=3.78, 95% CI: 1.85, 7.72), sleeping for a short duration (AOR=2.05, 95%CI: 1.30, 3.24), and having Family history of hypertension (AOR=2.12, 95% CI; 1.32, 3.39). Conclusions: Hypertension was significantly high among the rural population we studied and is emerging as a public health problem in rural areas. Female sex, older age, ever used alcohol, used much and too much amount of salt, inadequate sleep, and family history of hypertension were factors positively and significantly associated with hypertension. We recommend local health authorities integrate promotion of hypertension health education, lifestyle modification intervention on salt and alcohol reduction, and hypertension detection particularly for female and elderly population at health post level to avert the problem.