Background. Coronary heart disease (CHD) remains the most common cause of death among blacks, and the difference in CHD mortality between blacks and whites is growing. This trend may be due in part to higher rates of CHD risk factors among blacks. This study was done to determine the prevalence of CHD risk factors among a population-based sample of 403 rural blacks in Virginia. Methods. Community-based screening evaluations included the determination of exercise and smoking habits, blood pressure, height, weight, total and high-density lipoprotein (HDL) cholesterol, and glycosylated hemoglobin. Results. The prevalences of smoking (32.5% of men, 20.0% of women), high cholesterol (16.6% of men, 18.9% of women) and sedentary lifestyle (37.5% of men, 66.7% of women) were similar to prevalences reported for other black populations. However, the prevalences of diabetes (13.6% of men, 15.6% of women), hypertension (30.9% of men, 43.1% of women), and obesity (38.7% of men, 64.7% of women) were higher than those reported elsewhere. Increased body mass index was significantly associated with higher prevalences of hypertension, diabetes, and low HDL cholesterol. Conclusions. Innovative methods are needed to decrease the high risk factor prevalences among this population.