Background: In India, Cardiovascular diseases (CVDs) are the leading cause of death among both males and females and in urban as well as rural areas. Studies indicate that the risk of adverse health outcome increases with more number of unhealthy behaviors and moreover the behavioral risk factors often manifest themselves in specific pattern of combinations. Objectives: To study the pattern of clustering or combination of CVD risk factors in the study population and their associated factors. Results: In this study, 544 adults over the age of 20 years were included. Among them, 211(38.8%, 95%CI 32.3- 45.3)) had none of the risk factors for CVD, 215(39.5%, 95%CI 33.0%-46.0%) had single risk factors and 118(21.7%, 95%CI 14.3-29.1) had clustering of CVD risk factors. The overall clustering of CVD risk factors was higher for adults over the age of 40 years (78.0%) compared to adults less than 40 years (22%) and this difference was found statistically significant (p=0.01). The overall prevalence of clustering was higher among men [29.5%, 95%CI 22.2%-36.8%] than women [18.7%, 95%CI 14.8%-22.6%]. Age, male gender, alcoholism, physical inactivity, family income, educational status and occupation were positively associated with clustering of CVD risk factors. Conclusion: A sound community based comprehensive behavioral and life style intervention approach should be established to reduce the modifiable risk factors of CVD. In addition we should design a strategy to incorporate primordial prevention in the school education such as advocating healthy lifestyle (dietary habits, importance of exercise, avoiding smoking and alcohol etc).