Globally, about 10 million people die of non-communicable diseases (NCDs) related to unhealthy diets annually. NCD-related disability and mortality are rising across the Global South. However, few studies have examined diet-related risk factors and NCDs within the African context. Our study aims to address this gap by examining the relationship between food insecurity (FI) and NCD risk in Uganda. We performed secondary analysis of longitudinal data from a Population Health Surveillance cohort study being implemented in Wakiso and Hoima districts, Uganda. Data was collected between 2018-2024. We assessed the prevalence of FI and its associated covariates by NCD diagnosis for cancer, hypertension, heart disease and diabetes. NCDs was dichotomized as either at least one NCD or none. Using bivariate analyses, we interpreted adjusted risk ratios to examine NCD risk by food security status. FI and NCD data were collected at three time-points (n=4602, T1; n=4109, T2; n=5200, T3). Between T1 and T3, household FI increased by 5%, NCD prevalence remained the same, though, was higher among food-secure households compared to FI households by 44% (T1) and 38% (T3). Overall, the risk of NCDs increased by 23% (ARR: 1.23, CI: 1.07, 1.41) higher in food-secure households compared to FI households. FI continues to increase in Uganda, while NCDs are rising among food-secure households, partly due to increased economic means, which allow for increased intake of western-style diets. These findings are critical to inform policies and strategies aimed at strengthening prevention efforts in low-resource settings and improving health outcomes for high-risk populations.