Objectives: Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide. The aim of this study was to assess the association and diagnostic value of a novel uric acid index (UA index) to cardiovascular risk (CVR). Design: and Methods: An analytical cross-sectional study was performed. We analyzed data from the Plan for Prevention and Surveillance of Communicable and Non-Communicable Diseases at the Hospital de Huaycan, Peru. The QRISK model was used to measure the CVR. Stepwise regression models were performed to determine significant factors to predict CVR and formulate the UA index, then the association of UA index and high CVR was evaluated by Poisson regression models, and the diagnostic accuracy was verified through ROC curves. Results: In total 291 participants (206 women and 85 men) were analyzed. The correlation between UA index to CVR was stronger (R2:0.31, p < 0.001) than uric acid (UA) alone (R2:0.19, p < 0.001), and the contribution of UA was stronger than triglycerides or glucose in the stepwise regression model. In the Poisson models, the UA index adjusted model (PRa: 1.58, CI95% 1.11–2.24) presented significant independent association to CVR. The diagnostic accuracy was similar in men (cut-off: 10.8, AUC:0.81; 0.75–0.87) and women (cut-off: 10.0; AUC: 0.77, 0.71–0.84). Conclusion: UA index presented a good diagnostic accuracy and independent significant association to high CVR in adults from Peru. This marker can be used to assess CVR and follow therapeutic progress in primary health care.