Abstract Introduction There are few studies addressing the diabetes burden in the Nepalese population, and no studies on the prevalence of diabetes among Nepalese women. In this study, we, therefore, aimed to investigate the prevalence of diabetes and prediabetes, and associated risk factors among women in a rural district of Nepal.Methodology This is a cross-sectional study in which inclusion criteria were married, and non-pregnant women above 15 years of age. Exclusion criteria were physical and mental conditions that made participation difficult. Height, weight, blood pressure, waist circumference were measured, blood samples were collected and a questionnaire was filled in. Diabetes and prediabetes were classified according to the American Diabetes Association (ADA) as HbA1c > 6.5% and prediabetes 5.7-6.4%. Overweight and obesity were categorized according to the Asian cut-offs as recommended by WHO. Analysis of the data was done in SPSS version 20.0 (SPSS Inc, Chicago, USA).Results The study included 748 women with a mean age of 48.5 (SD= 11.8) years, the age range of 21- 81 years. The mean HbA1c level was 5.6 ± 0.8. The prevalence of diabetes and prediabetes was 4.4% and 34.0%, respectively. The prevalence of prediabetes and diabetes increased with age with an OR of 4.3 (95% CI: 2.36, 7.74, p < 0.001) and 10.3 (95% CI: 1.33,79.61, p<0.005), respectively in the age group >55 years compared to the youngest age group. Prediabetes was also prevalent in the youngest age groups. Overweight was observed in 38.4% of the total population and obesity in 24.5%. Among those with diabetes, 48.5 and 36.4 % were overweight and obese, respectively. Overweight, obesity, central obesity, and smoking were identified as risk factors for diabetes and/or prediabetes among those women aged more than 55 years. Fruit intake less than five times weekly was associated with decreased risk. Hypertension was also associated with prediabetes and diabetes. The awareness of diabetes was low in the study population.Conclusion The prevalence of diabetes and prediabetes among rural Nepalese women was high. Overweight/obesity and central obesity were frequent in the total population and even more so in those with diabetes. Risk factors were increasing age, overweight/obesity, central obesity, and smoking. women of those study areas. Increased attention is needed to reduce the burden of diabetes and its complications. Health education about diabetes, risk factors, and prevention should be initiated.