Background: Diabetes mellitus is a non communicable disease which is on the rise in Developing countries. Skin manifestations of diabetes are due to metabolic derangements or chronic degenerative complications. They are commonly observed after appearance of diabetes mellitus but may even precede the diagnosis of the disease. Aim: The aim of this study was to determine prevalence, spectrum of cutaneous manifestations of diabetes mellitus and its associated factors among patients attending diabetic clinic at KCMC Moshi, Tanzania. Methodology: This was a hospital based analytical cross-sectional study which included 544 patients with diabetes mellitus attending diabetes clinic at KCMC. Skin diseases were diagnosed clinically, however if the diagnosis wasn’t clear, histological diagnosis with laboratory backing was done to confirm the diagnosis. The study was from November 2013 to April 2014. Results: A total of 544 patients with diabetes mellitus were recruited. Majority (64.2%, n= 349) were females with male female ratio of 1:1.8 and mean age of 54.8 years (SD±18.4). The overall prevalence of cutaneous manifestations of diabetes was 43.9% (n=239) out of these, skin conditions associated with diabetes accounted for 56.1% (n=134). Infections accounted for 45.2% (n=108) of the cutaneous manifestations seen. Only 6.7% (n=16) of patients had skin conditions due to diabetes complications and only 7.5% (n=18) had skin reactions due to treatment. However, there was no association between cutaneous manifestations of diabetes with age, gender, type of diabetes, body mass index, type of treatment and duration of diabetes. Conclusion: Cutaneous manifestations of diabetes mellitus are common in our setting and skin conditions associated with diabetes and infections are the leading problems. Fungal infections are a major problem in our patients seen. Recommendation: Doctors should be made aware of cutaneous manifestations of diabetes as it might help them in early diagnosis of diabetes mellitus, as skin manifestations may be the first presentation.