A cross sectional survey to determine the mean systolic and diastolic blood pressure, prevalence of hypertension, and possible risk factors in two villages, Kychum and Njala Komboya, in Sierra Leone was carried out. A total of 463 subjects were investigated. Hypertension was defined according to WHO criteria, i.e. a systolic pressure equal or greater than 160 mmHg, and/or diastolic equal or greater than 95 mmHg. The mean systolic blood pressure for the total population was 131.39 +/- 26.85 mmHg and the mean diastolic blood pressure was 82 +/- 14.80 mmHg. There was no significant difference in blood pressure levels between the two villages. The mean prevalence of hypertension was 22.4%, with Kychum 17.6%, and Njala Komboya 24.8% (X2 = 1.11, p > 0.05). Systolic and diastolic blood pressure levels were associated with age, snuff, (ground tobacco), smoking tobacco leaf, kolanut consumption and parity, but all these associations disappeared when the sample was controlled for age. Age was therefore the most significant correlate of blood pressure. Blood pressure levels were not related to gender, body mass index or cigarette smoking. Hypertension on the other hand was only 4.8% among the subjects found to be hypertensive. These rural populations studied had higher blood pressure levels and higher prevalence of hypertension than similar populations in other African countries in spite of a low body mass index. These findings emphasize the need for more studies in other areas of Sierra Leone, especially urban areas, and calls for improved screening facilities for the early detection and treatment of hypertension in Sierra Leoneans.