Objective To assess the risk factors for prehypertension in Xinjiang Uygur population.Methods A cross-section study was conducted in a Xinjiang Uygur population (438 males and 716 females, aged 30 to 70 years). The fasting lipid profiles, serum glucose, insulin, and uric acid were determined. Homeostasis model assessment of insulin resistance (HOMA-IR) index was used to assess insulin resistance (IR). Binary logistic regression analysis was performed to determine risk factors for prehypertension. Blood pressure levels of normotensives and prehypertensives in different body mass index (BMI) categories were compared.Results Binary logistic regression analysis performed after adjustment for gender, lipids profiles, waist-to-hip ratio, uric acid, HOMA-IR, and lifestyle (alcohol drinking and smoking) showed a significantly increasing prevalence of prehypertension with BMI. The odds ratios for prehypertension against the lowest BMI group (separated by 24 and 28) were 1.934 and 2.490 (95% confidence interval: 1.435-2.606 and1.825-3.399, respectively). Age was independently correlated to the increasing prevalence of prehypertension. HOMA-IR was not associated with prehypertensive. The mean diastolic blood pressure (DBP) was significantly increased with BMI categories in either normotensives or prehypertensives (P<0.001) while the mean systolic blood pressure (SBP) was significantly increased with BMI only in normotensives (P<0.001).Conclusions In Xinjiang Uygurs, BMI and age was the risk factors for prehypertension. DBP is significantly increased with BMI. IR is not associated with prehypertension. These findings emphasize the importance of management of obesity for the control of blood pressure and other cardiovascular complications.