The study evaluates the prevalence, knowledge, attitude, and practices of non-communicable diseases (NCDs) among adult Orang Asli and Malay ethnicity in Negeri Sembilan, Malaysia. This cross-sectional study involving 634 respondents aged 18 years and above of Orang Asli (51.3%) and Malays (48.7%) from the rural villages. Structured interview questionnaire for disease history and KAP level conducted. Weight, height, waist circumference, blood pressure, and blood glucose levels then measured. Prevalence of NCDs was higher among Malays compared to Orang Asli with hypertension (35.0% vs 14.8%), hypercholesterolemia (31.1% vs 5.2%), and diabetes mellitus (16.2% vs 4.3%), respectively. Malays also had a higher percentage of being abdominal obese (70.6% vs 59.7%) and increased blood pressure (54.4% vs 29.8%). Multivariate analysis indicates hypercholesterolemia [OR=6.035 (95%CI: 3.150,11.561)], abdominal obesity [aOR= 1.807 (95%CI: 1.065, 3.067)], and increased in blood pressure [aOR= 2.359 (95%C1: 1.619,3.437)] have a significant relation with Malay ethnicity. For Orang Asli, 51.7% had poor knowledge, 72.3% had a good attitude, and 16.0% had a good practice. Knowledge and attitude scores were significantly less among Orang Asli with no significant difference for practice compared to the Malays. The prevalence of NCDs among the Malays is alarmingly high, with an increasing trend among Orang Asli, which needs immediate attention. The NCDs and obesity were significant among Malays but also showed a worrying trend in the Orang Asli as the good practice on a healthy life-style was low in both ethnicities. Thus, proper education and promotion regarding NCDs needed for diseases screening and prevention.