Background: Diabetes and its complications are a significant cause of morbidity and mortality in the community. Heart failure prevalence range from 3.9% in developed countries and 5.7% in developing especially in sub Saharan Africa on the other hand study shows that the trend for diabetes in expected to increase from 6.4% to 7.7% worldwide from 2010 to 2030. Most heart failure develop in patients with diabetes whether controlled or uncontrolled. This study aim to determine prevalence and the risk factors for development of heart failure among the diabetic patients attending clinic at KCMC hospital. Objectives: To determine the prevalence, and risk factors of heart failure among diabetic patients attending clinic at KCMC from January to December 2015. Methodology: This was a hospital based cross sectional study conducted at medical ward and medical records department at KCMC hospital from January to December 2015. Files of patients with diabetes type II was reviewed and data was filled in the data extraction form. Results: A sample of 150 patients were enrolled with the mean age (mean ±SD) of 63 (±11) years. A total of 46 patients with diabetes type II had heart failure making the prevalence of heart failure among diabetic patients attending clinic to be 30%. The odds for patients with the age of 76-85 was 5.4 times higher for developing heart failure compared to those in the age between 45-55 years(odds ratio=5.4, 95% confidence interval: 1.60-18.01; P=0.007). Those patients with hypertension showed that they are 3 times odds to develop heart failure compared to those without hypertension (odds ratio 3.8, 95% confidence interval: 1.38- 10.53; P-value=0.007). Conclusion: This study has revealed that among diabetic patients the prevalence of heart failure was found to be 30%. The following factors were independently associated with the developing heart failure among diabetic patients attending clinic at KCMC hospital age of the patient, insulin use either alone or in combination, hypertension and ischemic heart disease.