BACKGROUND AND AIMS: Assessing the prevalence of hypertension and associated determinants in riverine island populations is crucial due to their unique socio-environmental characteristics and restricted healthcare access, which increase sensitivity to hypertension-related problems and should lead targeted interventions. So, this study investigates the concerning issue of hypertension, focusing on its prevalence and influential factors among adults in Sirajganj's Riverine Island. METHODS: By employing a cross-sectional approach, the research utilized a structured questionnaire. A total of 309 people took part in this study via face-to-face interviews by following convenience sampling technique. The investigators performed frequency analysis for getting prevalence of HTN and other variable's percentage and binary logistic regression analysis for getting associated determinants. Analysis was conducted by using a statistical package for social sciences (SPSS) version 25. RESULTS: The prevalence of hypertension was 41% among all individuals. People who were illiterate were 1.23 times more hypertensive. Some key risk factors were discovered, including smoking ( CONCLUSION: People should consume a healthy diet and refrain from smoking. Regular physical activity and going to bed early are recommended. Medical camps and workshops should be held on riverine islands to promote a healthy lifestyle and prevent hypertension.