ABSTRACT Background:Non-Communicable Diseases (NCDs) are a leading cause of morbidity and mortality in India, contributing significantly to the national health burden. Puducherry has shown rising trends in lifestyle-related conditions; however, localized data on risk factors and health-seeking patterns remain limited. This study aimed to assess the prevalence of major NCD risk factors and examine treatment adherence among adults attending a tertiary care hospital in Puducherry. Methods:A hospital-based cross-sectional study was conducted among 420 adults aged 18 years and above at Tertiary Care Hospital. Data were collected using a pre-tested questionnaire adapted from the WHO STEPS tool, along with anthropometric and blood pressure measurements. Descriptive statistics, Chi-square tests, and logistic regression were used for analysis, with a significance level set at p<0.05. Results:Physical inactivity was highly prevalent (65.5%), followed by overweight/obesity (42.9%), hypertension (35.7%), alcohol use (28.6%), and tobacco use (21.4%). Although 80% of those diagnosed with NCDs were aware of their condition, only 40% adhered regularly to treatment. Older age, higher BMI, and family history showed significant associations with hypertension. Financial constraints and low perceived severity were key barriers to treatment adherence. Conclusion:The study highlights a substantial burden of modifiable NCD risk factors in the Puducherry population, along with inadequate treatment adherence. Strengthening routine screening, enhancing patient counseling, and implementing community-level health promotion strategies are essential to prevent and manage NCDs effectively in the region. Keywords: Non-Communicable Diseases (NCDs), Risk Factors, Physical Inactivity, Hypertension,Obesity, Health-Seeking Behavior