Objective To investigate pre-hypertension in aspects of its incidence, accompanied cardiovascular risk factors, and difference between urban and rural areas in Chengdu. Methods By cluster random sampling method, a total of 2 011 patients aged 35-70 years from urban and rural communities in Chengdu were selected as respondents. The investigation was conducted through questionnaire, physical examination and laboratory tests, so as to find out the main cardiovascular risk factors of pre-hypertension. All data were dual input into computer by a specially-assigned person. SPSS 13.0 software was used for analysis, Chi-square test was adopted for categorical data, and Plt;0.05 was taken as an index for significant difference. Results a) The incidence rate of pre-hypertensive in Chengdu was 33.6%, and it was 45.67% and 46.31% in urban and rural areas, respectively. In rural area, more male (51.04%) were affected than female (42.83%). b) The smoking population with pre-hypertension were mainly the male, and the ratio of rural male was 60% (132/220), far higher than that of urban male which was 32.6% (59/181). c) The pre-hypertensive population accompanied with diabetes was higher in urban (27.97%) than rural (14.01%). d) The pre-hypertensive population accompanied with hypercholesterolemia or low HDL was 33.04% (150/454) in urban, as twice as that in rural which was 16.41% (76/471). e) The pre-hypertensive population accompanied with abdominal obesity was far higher in urban (28.41%) than rural (12.74%). Conclusion Smoking is the risk factor which needs to be primarily intervened for male hypertensive patients in rural area. Impaired glucose tolerance is the common risk factor for both urban and rural residents, and hyperlipidemia is the most primarily risk factor for urban pre-hypertensive patients, followed by diabetes, and abdominal obesity.