There is a lack of information on the disease burden due to Taenia solium taeniasis and its associated risk factors in pig farming communities throughout the world. The present study was conducted in a rural pig farming community of north India to estimate the prevalence of T. solium taeniasis and associated factors. Demographic, clinical and epidemiological data were collected from 1181 subjects in 210 households in 30 villages. Stool specimens from 924 subjects were examined for eggs of Taenia and other parasites. Identification of T. solium was confirmed by morphological features of segments and species-specific DNA detection from segments and stool. The prevalence of T. solium taeniasis was 18.6% (172/924); factors associated with taeniasis on multivariate analysis were age above 15 years, history of passage of Taenia segments in stool, undercooked pork consumption and poor hand hygiene (hand-washing with clay/water after defecation). Seventy-eight subjects (6.6%) with epilepsy were identified. The study showed alarmingly high rates of epilepsy and T. solium taeniasis in the study community; it highlights the need for large-scale imaging-based surveys to identify the factors associated with epilepsy including neurocysticercosis. Health education, mass anthelminthic therapy and other preventive measures are required to control the menace of the disease.