OBJECTIVES: The study reported the utilization of oral anti-diabetic drugs (OADs), glycemic control, hypoglycemia and adverse events of type 2 diabetes mellitus (T2DM) patients with OADs therapy during their clinical visits in urban hospitals in China. METHODS: The study was a cross-sectional survey conducted at 75 hospitals in 9 cities in China. There were 9577 T2DM patients with OADs therapy completed the questionnaires. The survey period was from December 3, 2008 to July 31, 2009. Patients’ self-report on their diabetes condition and the latest health examination was used to evaluate the diabetes management situation. Descriptive statistics method was used for the analyses. RESULTS: A total of 51.1% of the patients were male, the mean age (±SD) was 59.5±12.7 years, and the mean duration of disease (±SD) was 7.9±6.3 years. The percentage of patients treated with biguanides, sulfonylurea, meglitinides, glitazones, α-glucosidase inhibitors, and others (including traditional Chinese medicine) were 78.4%, 65.1%, 14.0%, 12.6%, 31.1% and 18.1% respectively. Blood glucose control was inadequate, the mean HbA1c and fasting blood glucose were 9.1±2.4% and 9.4±3.4mmol/L respectively. Only 7.9% of the patients achieved the treatment target (HbA1c<6.5%). There were 15.3% patients experienced hypoglycemia episodes in the last 4 weeks, the mean hypoglycemia rates were 26.0/patient/year, of which major hypoglycemia rates were 7.8/patient/year, and nocturnal hypoglycemia rates were 6.5/patient/year. There were 60.3% OADs patients reported adverse events in the last 4 weeks, of which, 14.8% experienced digestive symptoms, 8.9% with skin allergies, 22.2% with blurred vision, 4.0% with liver and kidney damages. CONCLUSIONS: The majority of T2DM patients treated with OADs in China had suboptimal glycemic control. The adverse events of OADs treatment impose a high disease burden on patients. It underscores the urgent need for new therapies in the prevention and management of diabetes.