This descriptive, observational, cross-sectional study evaluated HTLV-1 and HTLV-2 infections in Ananindeua, northern Brazil. Individuals were screened for anti-HTLV-1/2 using ELISA (Murex HTLV-I + II, DiaSorin). Reactive or indeterminate samples underwent confirmation via Western blot (HTLV Blot 2.4 kit, MP Diagnostics) and/or RT-qPCR. A questionnaire examined behavioral and risk factors for HTLV-1/2 infection. HTLV-positive individuals received counseling, nurse follow-up, and specialized medical care. Among the 228 individuals investigated, 6 (2.7%) were infected with HTLV-1: 4 men (66.67%) and 2 women (33.33%), aged 51–73 years. The only significant risk factor observed was blood transfusion. Additionally, 80 other individuals residing in the municipality of Ananindeua independently visited the laboratory for an HTLV-1/2 diagnosis. Among them, 23 were diagnosed with HTLV-1 infection, and 1 with HTLV-2. Among the 30 positive individuals, 80% were asymptomatic, while 20% exhibited clinical manifestations associated with HTLV infection, including HAM and Sézary syndrome. These results indicate a notable prevalence of HTLV-1 infection in the municipality of Ananindeua emphasizing the significance of diagnosing the infection to assess its prevalence across the country accurately.