Background: Diabetes is a group of metabolic disorders that affect the body’s ability to process and use sugar (glucose) for energy. Type 2 diabetes mellitus resulting from the combination of resistance to insulin action and inadequate insulin secretion. The success of long-term maintenance therapy for diabetes depends largely on the patients’ adherence with self-care practices.Objective: The aim of this study was to assess diabetes self-care practices and associated factors among type 2 diabetic patients in Tikur Anbessa Specialized Hospital, Ethiopia. Method: institutional based cross sectional study was employed and 320 study subjects were selected using systematic random sampling technique. And the data was collected using interviewer administered structured questionnaire; data was analyzed and cleaned using SPSS version 16. Scoring method was employed to classify patients’ self-care practice level as adhered or not adhered to self-care practices.Results: Of all respondents 167(52.2%) female. Mean age of the respondents was 55.03±10.7 years with minimum age of 30 and maximum age of 85. The mean duration of diabetes was 12.3±7.6years with minimum of 6 months and maximum of 41 years. Respondents’ self-care practices were, the majority 270 (84.4%) respondents were not adhered to Self-Monitoring of blood glucose practice. A total of 311(97.2%) respondents were adhered to anti-diabetic medication. The majority 252 (78.8%) respondents were not adhered to recommended diet management practices. There was a significant association between Level of education, monthly income, Presence of glucometer at home, marital status, diabetic complication, age and gender and self-care practices. But there was no significant association between duration of diabetes, Occupation and family history of diabetic and self-care practices.Conclusion: findings of this study indicated that majority patients had poor adherence to self-care practices especially in self-monitoring of Blood Glucose and diet management practices.