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Hypertension and diabetes are global health problems with an incidence that is rapidly increasing worldwide. Depression is the most frequent mental health co-morbidity and is considered an important risk factor for the development of both diseases. This study aimed to determine the prevalence and factors associated with depression among Peruvian adults with hypertension and diabetes. We performed a secondary analysis of the 2017 Peru Demographic and Family Health Survey, using data from 10,566 adults aged 40 and older. The main outcome was depression assessed with the Patient Health Questionnaire-9 (PHQ-9). Other important variables were the diagnosis of hypertension or diabetes, sex, age, level of education, geographical region, wealth index, daily smoking, harmful alcohol consumption and physical disability. The overall prevalence of depression was 23.15% (CI 95%: 21.42%–24.88%) and among adults with hypertension and diabetes it was 34.96% (CI 95%: 29.33%–40.59%) and 35.56% (CI 95%: 24.49%–46.63%), respectively. Whereas the prevalence of depression among adults with type 2 diabetes mellitus (T2DM) was higher in the physical disability group (PRa: 1.28; CI 95%: 1.12–1.45), the prevalence of depression among adults with hypertension was higher in the female group (PRa: 1.36; CI 95%: 1.20–1.54) and among those with harmful alcohol consumption (PRa: 1.50; CI 95%: 1.01–2.24). Peru has a considerable burden of depression in the hypertensive and diabetic populations. While the variables positively associated with depression in hypertensive adults were female gender and harmful alcohol consumption, in adults with diabetes it was the presence of physical disability. • Depression is an important comorbidity among adults with non-communicable diseases (NCDs). • Peruvian adults with hypertension or diabetes had higher frequencies of depression compared to adults without these conditions. • Presence of disability, alcohol consumption and female gender were significantly associated with depression. • Mental health interventions are needed among adults with these NCDs. [ABSTRACT FROM AUTHOR]