Overweight and obesity are steadily rising in South Asia, the world’s most populous region. India, a low- and middle-income country in South Asia is experiencing an obesity epidemic. Built environment features may profoundly influence physical activity and counter the risk from overweight and obesity. This cross-sectional study investigated built environment correlates of overweight and obesity among adults (N = 370, 47.2% female, mean age = 37.9 years) in Chennai, India. Participants from low-socioeconomic status households were more likely to be overweight/obese (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–2.9) than participants from high-socioeconomic status households. Driving to work predicted a three-fold increase in overweight or obesity compared to active commuting (OR = 2.9, 95%CI = 1.3–6.4). Household car ownership was linked with an increased likelihood of overweight or obesity (OR = 1.5, 95%CI = 0.7–3.2). Low walkability neighbourhoods significantly predicted an increase in odds of overweight or obesity (OR = 1.8, 95%CI = 1.1–2.8). By 2030, Indian cities are projected to add 250 million people accompanied by a 9.9% annual motor vehicle growth rate. As car ownership increases across Southern Asia, there is an urgent need to develop interventions to promote physical activity.