Background <p>Health literacy is essential for individuals to access, understand, assess, and use health-related information. In riverside communities in the Brazilian Amazon, social vulnerability and difficult access to services make it urgent to understand how these communities deal with health information in their daily lives.</p> Objective <p>To identify the health literacy profiles of riverine communities in the Amazon region of Pará, northern Brazil.</p> Methods <p>This is a descriptive, cross-sectional study with 200 residents of the islands of Cotijuba and Combú in the state of Pará, Brazil, in 2024. A multidimensional questionnaire was used to assess health literacy. Cluster analysis allowed the identification of profiles with similar characteristics. The groups were described based on sociodemographic data, lifestyle, and performance on the nine assessed scales, and were named according to their main characteristics.</p> Results <p>Seventeen distinct profiles were identified. The greatest differences lie in the dimensions related to social support, to the search for reliable information, and to the ability to use healthcare services.</p> Conclusions <p>The heterogeneity in health literacy on the islands points to the need for targeted interventions, especially regarding navigating the system and understanding health information.</p>