Purpose <p>Anaemia is a persistent public health concern in rural India, influenced by socio-demographic factors. This study estimated the prevalence, severity, and types of anaemia and identified associated socio-demographic predictors among adults in rural Punjab.</p> Methods <p>The study was conducted in Mansa district, involving 1,620 adults aged ≥ 30 years. Socio-demographic data were collected using a structured interview schedule, and blood samples were analyzed using the Sysmex KX-21 haematology analyzer.</p> Results <p>Anaemia prevalence was 35.68%, with 15% experiencing moderate to severe cases. Females had nearly double the risk of anaemia compared to males (OR = 1.97, 95% CI: 1.32–2.96) and significantly higher odds of moderate to severe anaemia (OR = 3.33, 95% CI: 1.91–5.81). Vegetarians showed a higher risk than non-vegetarians (OR = 1.61, 95% CI: 1.21–2.16), and individuals with low income had elevated odds compared to higher-income participants (OR = 1.38, 95% CI: 1.05–1.81). Age was inversely associated with moderate to severe anaemia risk, particularly in participants aged 50–59 (OR = 0.40, 95% CI: 0.23–0.70) and 60–69 (OR = 0.47, 95% CI: 0.27–0.80). The stratified analysis revealed a higher prevalence of microcytosis and hypochromic conditions among anaemic individuals (<i>p</i> &lt; 0.01).</p> Conclusion <p>Anaemia remains highly prevalent in rural Punjab, driven by socio-demographic factors such as gender, diet, income, and age. Addressing these determinants through targeted interventions and comprehensive public health strategies beyond iron supplementation is crucial for mitigating anaemia burden.</p>