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Background & Objective: Health literacy is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions The aim of this study was to estimate the level of health literacy and to determine the factors influencing it using valid instrument Methods: In a Populationbased household survey in 5 cities and 5 villages of Boushehr Mazandaran Kermanshah Ghazvin and Tehran provinces 1086 adults aged 18 and older were enrolled into the study Health literacy was measured by the questionnaire designed for test of Functional Health Literacy in Adults (TOFHLA) after validation Regression analysis was used to determine the association of demographic factors and level of health literacy Results: The average response rate was 708% in the studied clusters From all participants 614% were female and the rest were male Mean age of participants was 381 years Seventeen percent of the study population was illiterate and 36% had diploma or higher education The level of health literacy was adequate in 281% borderline in 15 3% and inadequate in 565% of the subjects Mean score of health literacy was 453 in males and 411 in females (P=0057) However after adjustment for educational level in the regression model health literacy was found to be higher in females (P=014) Limited health literacy was also associated with lower economic status (P=0004)   Conclusion: This study indicates that the level of health literacy is low in Iran Educational level was the most important determinant of health literacy and the most increase was seen in …