Objective: The aim of this study was to determine the magnitude of the problem of obesity in El Shoara village, Damietta Governorate, to determine possible risk factors and to assess the possible health hazards. Methods: A cross sectional survey was conducted in two Egyptian Villages; El Shoara village which is famous for obesity and Alexandria Village where obesity was not so prevalent where 2000 subjects aged =20 years were screened by estimation of body mass index [BMI]. A case control study was adopted. [201 obese] from the El Shoara and [201 non obese] from Alexandria Village. Both cases and controls were subjected to: A questionnaire interview covering Socio-demographic data, KAP about obesity. Dietary data were collected by a standardized 24-hour dietary recall and Dietary assessment was carried out by the software program World Food Dietary Assessment Version 2.0. , History taking, thorough clinical examination and blood analysis for lipid profile was done. Levels of total physical activity were assessed. Results: The prevalence of obesity was highly significant in El Shoara village than Alexandria village, [20.8] and [9.8] respectively. In El Shoara village, the distribution of mild, moderate and severe obesity were 45.8%, 37.8% and 16.4% respectively with a statistical significant difference between females and males .From the case control study, there was no significant statistical difference between the obese and control persons as regards correct Knowledge about causes, ideal weight, complications and methods of prevention of obesity except for some knowledge. Most of the attitudes were significantly negative. The high social score was the highest risky social score [OR=14.5] followed by the middle social score [OR=7.4] while high housing condition score was the highest risky housing condition score [OR=15.2] followed by the middle housing condition score [OR=8.2]. The highest risky nutritional behaviors were; the habit of eating Mishabek and other Damietti sweets =Twice weekly [OR=2393.9] and monthly [OR=43.7] , food intake between meals [OR=210.4], eating more than three meals/day [OR=53.2], eating more than two rice servings/day [OR=39.8], eating more than three breads/day [OR=21.1], preference of fried meals [OR=193], taking more than two sugary beverages/day [OR=16.8], taking more than two food servings rich in animal fat [OR=15.8], taking more than five sugar teaspoonfuls/day [OR=13.8] and night eating [OR=2.9]. the highest risky physical activity scores were light physical activity [OR=134.8] and moderate physical activity scores [OR=6.8].Other risk factors were family history [OR=3.1], sedentary life style mainly lack of daily walk = one hour [OR=68.5], non-exercise practice [OR=42.2], TV watching > 4 hours /day [OR=14.9], lack of sleep > 8 hour /day [OR=12.8]and non-manual work [OR=5.2]; psychological factors as unemployment (OR=5.9], being single or divorced [OR=2.1] and history of hormonal contraception [OR=4.4], There was a statistical significant difference between obese and control as regards the mean daily nutrient intake from total energy, total fat, saturated fat, polyunsaturated fat , cholesterol land carbohydrates. The most prevalent complications with significant statistical difference among the obese patients were diabetes [22.4%], osteoarthritis (20.9%), psychological disorders (19.9%), coronary heart disease (18.9%), hypertension (15.4%), gallstones and gout (14.4% for each) and sleep and respiratory problems (8.5%). The mean levels of serum total cholesterol, serum triglycerides, serum low-density ipoprotein cholesterol LDL-C, and serum uric acid were significantly higher among the obese cases compared to the control while serum high-density lipoprotein cholesterol HDL-C whicn is protective was significantly higher among controls than obese cases. Further survey studies in similar rural areas are recommended and the issue of obesity and other non-communicable disease should be addressed on the primary health care level including rural areas with similar conditions and specific strategies including dietary management, physical activity, exercise programmes, behaviour modification are recommended.