Objective: The aims of this study were to estimate the prevalence and correlates of self-rated oral health (=SROH) among adults in a national population-based survey in Ecuador. Materials and Methods: In the national cross-sectional 2018 Ecuador STEPS survey, 4,638 persons (median age = 39 years, range 18–69 years) responded to a questionnaire, physical measures, and biomedical tests. Results: The prevalence of poor SROH was 9.7%, 10.1% among females and 9.4% among males. In multivariable logistic regression analysis, aged 50–69 years [adjusted odds ratio (AOR): 3.06, 95% confidence interval (CI): 1.99, 4.72], Amerindian (AOR: 1.78, 95% CI: 1.23, 1.58), pain in the teeth/mouth (AOR: 2.03, 95% CI: 1.51, 2.73), impaired OHRQoL (OR: 3.94, 95% CI: 2.93, 5.29), dental visit more than past 12 months ago or never (AOR: 1.74, 95% CI: 1.32, 2.29), past smoking (AOR: 1.50, 95% CI: 1.08, 2.09) and history of heart attack or stroke (AOR: 1.57, 95% CI: 1.04, 2.37) were positively and having more than secondary education (AOR: 0.63, 95% CI: 0.43, 0.92) and teeth cleaning (≥twice/day) (AOR: 0.48, 95% CI: 0.37, 0.64) were negatively associated with poor SROH. Conclusions: One in ten participants reported poor SROH and several factors associated with poor SROH were found that can aid in designing programs to improve SROH in Ecuador.