The objectives of this study are to evaluate the prevalence of radiographic hand osteoarthritis (OA) in Chuvashian community-based sample and its associations with age, sex, body mass index (BMI), smoking, and alcohol consumption. The study population was comprised of Chuvashians (443 males, age 47.4 ± 17.0 years and 384 females, age 50.8 ± 16.3 years). OA was evaluated for 14 joints of each hand according to the Kellgren and Lawrence grading scheme. Statistical analyses included prevalence estimation, linear, logistic and polynomial regressions, and χ2 tests. After the age of 65 years, 89.2% of males and 97.6% of females had at least one affected joint. For males and females the best-fitted and most parsimonious model of association between age and number of affected hand joints was the two interval linear one. After adjustment for age, no association between prevalence of hand OA and BMI was found in males. However, females with obesity have almost three times higher risk of development of hand OA than those with normal weight. No association was found between smoking and prevalence of hand OA. Moderate alcohol consumption showed protective effect on prevalence of hand OA in women.