INTRODUCTION: Cardiovascular diseases (CVDs) are the leading cause of death globally, and in Australia. Centralised approaches for prevention of CVDs may not suit rural/regional requirements as the risk distribution at smaller regions may significantly differ from larger areas. Understanding small-area geographic distribution of cardiometabolic risk factors (CMRFs) can inform resource planning and preventive services based on actual need, and can aid in subsequent rural/regional healthcare policy developments. OBJECTIVE: Quantify small-area geographic variance in distribution of CMRFs. METHODS: A cross-sectional hierarchical design and geospatial methods were used in this study to estimate and map the small-area geographic variability in CMRFs. The study area comprises Illawarra Shoalhaven region of the NSW Australia, which covers a land mass of 5615 square-kilometres and an estimated resident population of 389157 on 30 June 2010. Routine test results on selected CMRFs such as high blood glucose, cholesterol, BMI and low kidney function values - recorded between 2012 and 2016 were extracted from a major laboratory network database in study area. Statistical Area Level-1(SA1) as defined by Australian Statistical Geography Standard (ASGS) is the small-area scale used, and the statistical variance at each level of data and its extent of variation with introduction of selected independent variables were analysed through multilevel models and the best-fit model is chosen for illustration. RESULTS: Cardiometabolic risk map of the study region, along with its epidemiological findings. CONCLUSION: The study findings have the potential to resource local-area health care service planning for the prevention and management of CVDs at rural/regional levels.