Communicable diseases (CD) are the main cause of death around the world for years followed by non-communicable diseases (NCD) causing major problems in industrialized countries. Among all NCDs and CDs, Cancers (NCD) and Tuberculosis (CD) constitute the major cause of morbidity and mortality in developing countries, including India. The specific aim of this study is to quantify the prevalence of communicable (Tuberculosis) and non communicable diseases (Cancers) in urban and rural areas of Tirupati and to analyze the relative epidemic using a comparable framework. The data was analyzed statistically using Chi-Square test and Odds ratio with 95% confidence interval. All analyses were performed with SPSS version 13 software. Compared to rural areas, people from Urban areas of Tirupati (52.1% Vs 47.9%) has increased risk of NCDs: patients with Breast Cancer (33% ), Cervical Cancer (35%), Oral Cancer (8.9%), Prostrate Cancer (6.3%), Skin Cancer (4%) and Other Cancers (12.9%) like Bladder, Colon, Lung, Rectal, Stomach, Uterine. There was a significant urban-rural difference in having Tuberculosis in the years 2010 to 2011 (71.4% vs 28.6%, respectively; P __ampersandsignlt; 0.001) and there was a significant urban-rural difference in Communicable and non communicable diseases in the years 2010-2011(54.1% vs 45.9%, respectively; P = 0.03). These finding suggests that there is an increasing prevalence of Communicable and non communicable diseases in Tirupati as a result of lifestyle changes and urbanization. These are the challenges that are to be tackled in new millennium.