Background: Impaired fasting glucose level has been associated with increased incidence of Type 2 Diabetes mellitus, and diabetes is becoming a major public health problem in developing countries. The objective of the study was to determine the prevalence and correlates for impaired fasting glucose level/diabetes in Kaoma and Kasama rural districts of Zambia. Methods and Findings: A cross sectional study using modified World Health Organization (WHO) global non communicable diseases (NCD) surveillance initiative NCD STEPwise approach was used in the study. Proportions were compared using the Yates’ corrected Chi-square test, and a result yielding a p value of less than 5% was considered statistically significant. Bivariate and multivariate logistic regression analyses were conducted. Factors that were statistically significantly associated with the outcome in bivariate analyses were considered in a multivariate logistic regression analysis using a backward variable selection method. Odds ratios (OR) and their 95% confidence intervals (CI) have been reported. Totals of 895 participants from Kaoma and 1198 from Kasama took part in the surveys. Overall, 4.1% of the participants in Kaoma and 1.8% of the participants in Kasama (p=0.004) had impaired fasting glucose level/diabetes, with no significant differences between sex in both districts. Respondents who were aged less than 45 years were less likely to have impaired glucose level/diabetes compared to those who were aged 45 years or older (OR=0.56, 95% CI [0.39, 0.81] in Kaoma and OR=0.55, 95% CI [0.33, 0.89] in Kasama). Conclusions: Prevalence of impaired fasting glucose level/diabetes may have been underestimated because impaired glucose test was not conducted. The prevalence of impaired fasting glucose level/diabetes varied between the two rural districts studied. Impaired fasting glucose level/diabetes was associated with age. Interventions to control diabetes should be district specific and targeted at younger age groups in order to curtail the prevalence of diabetes in older age groups.