Abstract: Introduction: Overweight and obesity are significant global public health challenges associated with adverse burdens on the quality of life and mortality due to their association with non-communicable diseases. Early identification and control of these conditions are vital to mitigating their impact. Methods: A cross-sectional study was conducted among 339 respondents in Ilala City (urban) and Mkuranga district (rural) to assess the prevalence and determinants of overweight and obesity among adults. Data were collected on lifestyle, nutrition and demographic characteristics, and anthropometric measurements of height, weight, fat mass%, and waist and hip circumference were measured. Statistical analysis was conducted using SPSS version 27. Results: The overall prevalence of overweight and obesity was 26% and 18.9% respectively. In Ilala City, 61.1% of respondents was either overweight (32.2% or obese (28.7%), and in Mkuranga district, the prevalence of overweight was 19.2% and that of obesity was 8.3%. Key factors negatively associated with overweight and obesity included rural residence (AOR = 0.25; 95%CI (0.14 – 0.47); P = 0.000), income (AOR = 0.2; 95%CI (0.1 – 0.5); P = 0.001), Vigorous physical activities (COR = 0.5; 95%CI (0.3 – 0.7); P =0.002), and consumption of pulses (legumes, nuts and oil seeds) (AOR = 0.1:95%CI (0.01 – 0.2); P = 0.026), and positively associated with sex (AOR = 3.65; 95%CI (2.1 – 6.3); P = 0.000), where by female respondents were more overweight or obese than males, low education (AOR = 7.6; 95%CI (1.2 – 48.5); P = 0.03) in which primary school education were at higher risk of being overweight or obese, and spending less than 75 minutes per week for vigorous physical activities (COR = 2.6; 95%CI (1.7 – 4.12); P = 0.000) were by respondents with sedentary lifestyle are at higher risk of being overweight or obese. Conclusion: The findings suggest that urbanization, sex, education level, physical activity, and dietary habits are significant predictors of overweight and obesity. This serves as a benchmark for planning further studies aiming at reducing the prevalence of overweight and obesity among the adult population through well-designed interventions.Abstract: Introduction: Overweight and obesity are significant global public health challenges associated with adverse burdens on the quality of life and mortality due to their association with non-communicable diseases. Early identification and control of these conditions are vital to mitigating their impact. Methods: A cross-sectional study was conducted a...Show More