Despite the availability of efficacious anti diabetic drugs, which act by different mechanisms to reduce the blood glucose, the majority of people with diabetes on anti-diabetic drug therapy, have poor glycemic control and diabetic vascular complications. Aims & Objectives: This study was conducted to assess the prevalence of drug therapy problems and related factors in a population of diabetic patients in a tertiary hospital. Materials and Method: A prospective observational study was conducted Department of General Medicine in Karuna Medical College Hospital, Vilayodi, Chittur, Palakkad, Kerala, 500 bedded multi-specialty tertiary care teaching hospital located in rural India for 6 months. The study is based on the data collection from 92 patients who were aged >30 years old and above of either gender with T2DM in a tertiary care hospital. The identification and assessment of DRPs were based on the Pharmaceutical Care Network Europe (PCNE) tool version 5.01. Results: This study identified 1147 drug-related problems (DRPs) across the ten categories which were Drug interactions (688), Non-Compliance (71), Indication without the drug (63), ADRs 159, Duration of therapy too short 49, Therapeutic Duplication 47, Drug not most appropriate for the indication (35), Drug Disease Interactions(18), Drug without indication(13) and Duration of therapy too long(4).Conclusion: Early identification and prevention of DRPs in type 2 DM and rational use of drugs are necessary to prevent complications and unnecessary hospitalization, high cause of treatment, and death among diabetic patients. Pharmacists play important roles in identifying and resolving DRPs through direct communication with the patients, prescribers, as well as other health care providers