Background: There are no data available on the prevalence of non-communicable diseases (NCD) risk factors among the tribal population of hill state of Himachal Pradesh (HP). The epidemiological study of NCD risk factors was done in the tribal population of district Kinnaur of HP to estimate the burden of NCD risk factors and their risk determinants. Methods: WHO STEP wise approach was used for screening of the core NCD risk indicators in 3582 randomly selected natives of Kinnaur aged 20–70 years by trained Health workers of the district health services. Results: The hypertension was prevalent in 19.7% (18.4–21.1%) and diabetes in 6.9% (6.1–7.8%) of the population. Awareness of hypertension and diabetes was 39.8% and 40.8% respectively. The adherence to prescribed medications was reported in 52.1% and 56.4% of patients of aware hypertension and diabetes respectively. Overall, 23.3% and 8.5% of the patients with hypertension and diabetes had controlled BP and blood glucose respectively. Overweight and obesity were observed in 38.2% (36.6–39.9%) and 8.8% (7.9–9.8%) of the population respectively. The consumption of tobacco and alcohol was reported in 22.6% and 24.9% of the population, respectively, and 34.5% were physically inactive. Physical inactivity, BMI, high alcohol consumption, and age were independently associated with risk of hypertension, while age was the only determinant of risk of diabetes. Education and women gender had a significant influence on tobacco and alcohol consumption behavior adjusted for age. Conclusion: NCD risk factors are prevalent in the tribal district of Kinnaur. The awareness, treatment, control of blood pressure and blood glucose were found to be suboptimum in the study subjects. Interpretation: Strengthening of primary health care services and community based interventions are urgently required to improve awareness and control of NCD risk factors in this tribal district of HP.