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 diabetics drug therapy, have poor glycemic control and diabetic vascular complications. Aims & Objectives: The aim was to assess the prescribing patterns in type 2 diabetes mellitus patients admitted in tertiary care teaching 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 a period of 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. Prescriptions of the patients are collected in a designed questionnaire form and the relevant information is recorded and analysed. Results: In this study, 92 Patient prescription patterns were studied out of which male (54.3 %) and female (45.6 %) were analysed . The mean age was 64.8 years .The most common drugs that were used in type 2 DM patient’s were metformin(75%), glimepiride(38.04%) ,Voglibose(14.1%), Gliptines (7.6 %) , Gliclazide (5.43%,) other anti-hyperglycemic drugs (6.5 %) ,insulin(99%). Hypertension was the most commonly found comorbid conditions. In which Angiotensin receptor blocker (35.1%), Diuretics (25.5%) , Beta blocker (17.02 %) were prescribed . Poly pharmacy and multiple co morbidities were common in this patient population. Conclusion: Most of the patients were prescribed with >10 drugs during hospitalisation which resulted in hypoglycaemia. Oral hypoglycemic agents still dominate the prescribing pattern but there was a shifting trend towards the use of insulin preparations