To determine the prevalence and risk factors related to systemic arterial hypertension (SAH) in the rural marginated population of Durango, Mexico. A comparative cross-sectional study was performed in 627 rural communities, approximately 90% of which have 250 inhabitants or less. The arterial pressure and sociodemographic variables were determined. A total of 5,802 subjects were studied, 4,452 women (76.7%) and 1,350 men (23.3%). SAH was found in 1,271 individuals (21.9%; CI 95% 20.8-23.0) of which 1,011 were women (22.71%; CI 95% 21.5-23.9) and 260 were men (19.26%; CI 95% 17.2-21.4). Of the target population, 3,018 individuals (52.0%) live in communities of less than 250 inhabitants, 2,080 (60.9%) women and 938 (31.1%) men. In this group, SAH was identified in 445 cases (14.74%; CI 95% 13.5-16.0) of which 326 are women (15.7%; CI 95% 14.1-17.3) and 119, men (12.7%; CI 95% 10.6-14.9). The main risk factors related to SAH were obesity, type 2 diabetes, alcohol and tobacco consumption. The prevalence of SAH in the rural marginated population is apparently related to the degree of development of the communities.