Background: Hypertension is common in developing countries and most of its risk factors are preventable. Objective: This study aims to estimate the prevalence and risk factors of hypertension among rural adults in an Egyptian village. Method: a nested case-control study was carried out in Meet El-Amel village, Aga District, Dakahlia Governorate it was targeting adult subjects aged from 18 years and more, pregnant and lactating women were excluded. The mean age of participants was 44.6±15.9 years. Results: the overall prevalence of hypertension was 31.9%. Multivariate logistic regression model has identified that being a woman (AOR= 46.5), being adherent to drug therapy (AOR= 40.3) and secondary or higher education levels (AOR= 14.8) as the only predictors for controlled hypertension among self-reported hypertensive. Excess salt (AOR= 17.5), smokers (AOR=5.8), obesity (AOR=5.1), high cholesterol (AOR=4.8), those belonging to 40-59 age group (AOR=3.5), low HDL (3.2), positive family history of hypertension (AOR= 3.1), physical inactivity (AOR= 2.9), those ≥ 60 years old (AOR=2.8) and men gender (AOR=2.3) are predictors of newly discovered hypertension. Conclusion: primary prevention of modifiable risk factors of hypertension is crucial.