Background: Prevalence of dyspepsia varied worldwide, including in India. Studies from India reported a prevalence between 14.9 to 30.4%. Risk factors associated with dyspepsia are Helicobacter pylori infection, predominantly vegetarianism, smoking, and tobacco chewing. Most of the studies have not evaluated patients with dyspepsia using esophagogastroduodenoscopy. There is a scarcity of literature estimating the prevalence from India’s rural population. The present study is designed to estimate the prevalence of dyspepsia, study the associated risk factors including dietary factors, and evaluate using esophagogastroduodenoscopy. Methods: It is a community-based cross-sectional study carried out using Rome III criteria. Multi-staged sampling was done and data was collected by house-to-house survey. The subjects with dyspepsia were mobilized to undergo esophagogastroduodenoscopy. The data were analyzed using SPSS and a two-tailed p-value < 0.05 was considered significant. Results: Prevalence of dyspepsia in the rural community was found to be 29.6%. In univariate model, associated risk factors of dyspepsia were older age group, predominantly vegetarian diet, regular tea intake, chewing tobacco, smoking, and gudakhu use. In multivariate analysis, only smoking tobacco was found to be significantly associated. Endoscopic evaluation revealed 56% had functional dyspepsia. Abnormal findings reported were esophagitis (26%), antral gastritis (9%), antral ulcer (7%), and inflammatory esophageal polyp (2%). Conclusion: Dyspepsia is a very common disease in Odisha with the majority diagnosed with functional dyspepsia. Smoking tobacco was found to be an independent risk factor for dyspepsia. Further studies using Rome IV criteria are recommended.