Objective: To investigate the prevalence and influencing factors of chronic diseases among adult residents in Hunan Province, so as to provide insights into management of chronic diseases. Methods: Permanent residents at ages of 18 years and older were sampled using a multi-stage random sampling method in Hunan Province from April to June, 2021, and participants' demographics, smoking, alcohol consumption, sleep quality and development of chronic diseases were collected using questionnaire surveys. The prevalence of chronic diseases was estimated and standardized by the seventh national population census data. In addition, the factors affecting the prevalence of chronic diseases were identified using a multivariable logistic regression model. Results: A total of qualified 9 469 adult residents were enrolled, including 4 678 men (49.40%) and 4 791 women (50.60%), with a mean age of (59.37±14.14) years. The overall prevalence and standardized prevalence rates of chronic diseases were 50.84% and 38.44%, respectively, and the prevalence and standardized prevalence rates of hypertension, protrusion of intervertebral disc and diabetes were 18.66% and 15.06%, 6.31% and 5.28%, and 4.44% and 4.18%, respectively. Multivariable logistic regression analysis revealed that women (OR=1.252, 95%CI: 1.131-1.386), age (45 years-, OR=3.699, 95%CI: 3.104-4.407; 60 years and older, OR=9.255, 95%CI: 7.743-11.064), unmarried/divorced/widowed (OR=1.170, 95%CI: 1.036-1.321), educational level (junior high school, OR=0.730, 95%CI: 0.653-0.816; high school/technical secondary school, OR=0.710, 95%CI: 0.609-0.827; diploma and above, OR=0.586, 95%CI: 0.454-0.758), monthly household income (3 000 yuan-, OR=0.846, 95%CI: 0.759-0.943; 6 000 yuan-, OR=0.819, 95%CI: 0.710-0.943; 10 000 yuan and higher, OR=0.790, 95%CI: 0.657-0.950), smoking (OR=1.528, 95%CI: 1.363-1.713), insomnia (OR=2.637, 95%CI: 2.271-3.063) statistically correlated with the development of chronic diseases. Conclusion The prevalence of chronic diseases was 50.84% among adult residents in Hunan Province in 2021, and hypertension was the predominant chronic disease. Women, the middle-aged and elderly residents, residents with a low educational level and residents with low incomes are at a high risk of developing chronic diseases.