Limited studies evaluating the prevalence of cardiovascular risk (CVR) in resource-poor black communities in South Africa (SA), exist. The objective of this chapter is to evaluate the prevalence of CVR in a cross-sectional studies in randomly selected low income children, adults and elderly in Gauteng, Free State and Eastern Cape, SA. The test panel of CVR markers included: anthropometry, lipid profile, blood pressure, fibrinogen, high sensitiveâCâreactive protein (HSâCRP), homocysteine, vitamin B12, folate, glucose and dietary intakes. The main findings indicated high CVR with prevalence of overweight/obesity, Hypertension, hyperhomocysteinaemia, increased fibrinogen and HS-CRP, as well as low intakes of dietary fibre, vitamins B6 and B12, folate and polyunsaturated- and monounsaturated fatty acids, and high intakes of dietary sodium, saturated and trans fatty acids, and added sugars. Multiple CVR factors are present among all the communities. It can thus be concluded that a double burden of poverty and risk of CVD exists across the different age groups and geographical locations in these resource-poor communities.