Background: Data on Substance abuse, its prevalence, Pattern of use, determinants and predictors are extremely limited in Punjab. A study by the State’s Department of Social Security Development of Women and Children in the year 2012, suggests that 67% of rural households in Punjab had at least one drug addict in the family. Environmental conditions have substantial role to indulge into habit of substance use. Objectives: Estimation of Prevalence of substance abuse, determining pattern of Substance abuse, Socio-demographic determinants, Correlates and predictors of substance use in district Patiala (Rural), Punjab, India during year 2014-2015. Methods: Present study is an observational cross-sectional quantitative study based on a sample of 311 conducted in three administrative blocks of district Patiala (Rural) from 1st May to 31st August, 2015. The Ethical Committee of the School of Public Health, Jodhpur National University, Jodhpur approved this study. It included screening for participants, took informed consent, data collection by interviewing on the basis of pre-tested, detailed questionnaire (Schedule), recorded by Investigator and Statistical analysis was done by professional statistician by using software Microsoft Excel 2010. To make diagnosis of substance dependence, ICD-10 criteria were applied. Results: Prevalence of Substance abuse in District Patiala (Rural) was found 73.63%. Alcohol abuse 18.38%, drug abuse 17.04% and Multiple substance abuse 38.26% was prevalent among the sample. Desi (country) liquor was found to be more commonly consumed (48.87%). Tobacco products were found highly prevalent (47.59%) after Alcohol, followed by Opioids (19.94%), Cannabinoids (09.00%) and then Pharmaceutical drugs (06.43%). Zarda (Chewable tobacco) 51.09% and Poppy husk (Bhooki) 18.78% were found highly prevalent among rural addicts. Socio-demographic factors associated with substance abuse were age 21-30(33.62%),males 99.13%, Jat Sikhs 51.97%, general caste 55.02%, married 72.93%, farmers 32.31%, Labrourers 26.20%, elementary to secondary education 51.53%, nuclear family 53.28% and income below INR 5000 to 10000 (59.39%). Correlates significantly associated with substance addiction found were Place of first use of substance (p=0.006), Frequency of substance use per day (p=0.0001). Impact of substance abuse significantly associated was Disapproved social behaviour (p=0.012), Impact on health (p=0.0009), Social and relationship problems (p=0.004). Predictors of study among rural were men (cOR=113.5, 95%CI=26.42-487.64, p<0.0001), Age >45 (cOR=2.96, 95%CI=1.12-7.83, p=0.028),married (cOR=2.69, 95%CI=1.59-4.54, p=0.0002), self-employed (cOR=6.92, 95%CI=3.18-15.02, p<0.0001), nuclear families (cOR=2.08, 95%CI=1.24-3.51, p=0.005) which were more likely to abuse substance and other predictors were curiosity, easy availability of substance, lack of family support. Conclusion: High prevalence of substance abuse found in district Patiala. There is need to expand the study to other districts of Punjab and need to change environmental conditions to build a system that is designed to help drug addicts to reconnect with the world.