This study examines the emergence of non-communicable diseases (NCDs) among tribal populations in North Maharashtra, India, with a focus on the districts of Nandurbar, Dhule, and Jalgaon. A cross-sectional survey was conducted between 2022 and 2023, covering 400 households selected through multistage stratified random sampling, supplemented with secondary data from NFHS-5. Using village-scale GIS mapping, epidemiological survey data, and Random Forest modeling, the study analyzed the prevalence and spatial distribution of major NCDs—cardiovascular diseases, diabetes, hypertension, and chronic respiratory illnesses. Results showed a prevalence of 32.4% for cardiovascular diseases, 28.7% for diabetes, 25.6% for hypertension, and 21.3% for chronic respiratory diseases, with comorbidity observed in 43.2% of cases. High-risk clusters were identified in Nandurbar, with spatial autocorrelation values (Moran’s I = 0.67, p < 0.001) indicating significant clustering. Environmental factors such as elevation, distance to healthcare facilities, and socioeconomic determinants were strongly correlated with NCD prevalence (r = 0.45–0.72, p < 0.01). The findings highlight the urgent need for geographically and culturally sensitive public health policies, improved healthcare accessibility, and targeted community-based interventions, including mobile health units and integration of traditional practices with modern medicine, to address the rising NCD burden in tribal populations.