BackgroundCameroon, like many other developing countries, is experiencing a double burden of malnutrition. With increasing urbanization, communities are exposed to high calorie diets and sedentary lifestyles, which contribute to overnutrition. However, the nutritional status of the communities may vary with geographic location. The aim of the current study was to investigate the prevalence of underweight, overweight and abdominal obesity among adults as well as overweight, underweight, stunting and wasting among children in selected urban and rural communities of the North West Region (NWR) of Cameroon. The study also compared these parameters between selected urban and rural areas.MethodsCross-sectional study design was used to investigate the anthropometric status of adults (18–65 years) and children (1–5 years) from two rural (Mankon and Mendakwe) and two urban (Mankon and Nkwen) communities in the NWR of Cameroon. The study included 156 adults and 156 children per study site from different households. A multistage sampling technique was used to select the participants and study sites Anthropometric measurements were taken using standardised methods for selected indices: weight, height, waist circumference and mid-upper arm circumference (MUAC). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25 and ap-value of < 0.05 was considered statistically significant.ResultsAdults from Nkwen (urban) were either overweight (n= 74; 47.4%) or obese (n= 44; 28.2%) with 43.6% (n= 68) from urban Mankon obese, whilst adults from rural Mankon were normal weight (49.4%;n= 77), 2.6% (n= 4) from Mendakwe (rural) were underweight and 64.1% (n= 100) were normal weight. Children in the rural areas were severely underweight (n= 45; 14.4%), while children in the urban areas were either normal (n= 158; 50.6) or overweight (n= 43; 13.8%). More females in the urban sites (n= 39; 53.4% in Nkwen andn= 43; 69.4% in urban Mankon) had a large waist circumference (WC) compared to those in the rural sites (n= 17; 22.1% in Mendakwe andn= 24; 38.1% in rural Mankon). Males in the urban areas had large WC compared to those in the rural sites (n= 19; 24.4% in Nkwen;n= 23; 24.7% in urban Mankon;n= 15; 16.1% in rural Mankon andn= 2; 2.6% in Mendakwe). Mid-upper arm circumference (MUAC) values indicated that most children in both urban (n= 147; 94.2% in Nkwen;n= 152; 97.4% in urban Mankon) and rural areas (n= 142; 91.0% in rural Mankon;n= 154; 98.7% in Mendakwe) were not acutely malnourished.ConclusionsThis study found a higher prevalence of overweight and obesity among adults and children in the urban areas of Nkwen and Mankon, compared to rural Mankon and Mendakwe. Thus, there is a need to investigate and address the causes of the high prevalence of overweight and obesity in these urban areas.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40795-023-00734-9.