Background Non-communicable diseases (NCDs), accounting for nearly one third of global deaths were diseases of public concern in developed countries. Due to economic transition, now NCDs are becoming more prevalent in middle and low-income countries (LMICs). However, little has been done about NCDs among young adults in LMICs, Tanzania in particular. Traditionally, health systems thought that this subpopulation has an active life style and therefore not at risk of NCDs hence left without intervention. But current research evidences indicated a gradual increase of NCDs among young adults especially to those living in urban. Therefore, a study was conducted to determine the magnitude of diabetes mellitus, obesity, dyslipidemia and hypertension among young adults from Mwanza urban areas. Methods A community based cross-sectional was conducted between May and August 2018 from an urban settings in Mwanza, Northern Tanzania. Case report forms (CRFs) were used to collect participants’ demographic information, clinical assessment and laboratory measurements. Descriptive statistics were summarized using frequencies and percentages. The association between dependent and independent variables were analyzed using Chi-square test. All statistical analysis was performed using STATA version 13 and type 1 error for signifi¬cance was 0.05. Results Overall 259 young adults were recruited. The median age [interquartile range (IQR)] was 21 (IQR: 19 -27), the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) were 8% (259) and 16% (259) respectively. Overweight, obesity and dyslipidemia were present in 17%, 8.1% and 44.4% of the studied population (259) respectively. The prevalence of hypertension was 35.1%, more prevalent in males than females (52.4% vs. 32.7%; p = 0.002). Physical inactivity was significantly associated with isolated systolic hypertension (p = 0.009) and elevated mean arterial pressure (MAP) (p = 0.004). High Body Mass Index (BMI) was significantly associated with elevated mean arterial pressure (MAP) (p = 0.03) and dyslipidemia (p = 0.018). Conclusion Alarmingly high prevalence of diabetes, impaired glucose tolerance, hypertension, overweight, obesity and dyslipidemia was observed among young adults in Mwanza. This study highlights the need for concerted efforts targeting young adults in combating NCDs in Tanzania. Key Words: Diabetes, Hypertension, Obesity, Dyslipidemia, Young Adults