OBJECTIVES: To determine the financial cost of diabetes management to Cocoa clinics for 2009. METHODS: A descriptive cross-sectional study of diabetes management at the four Cocoa clinics in Ghana from May to July 2010 was conducted.  The prevalence-based ‘Cost-of-illness’ approach from the institutional perspective was employed. A pre-tested data extraction form was used to review the medical records of 304 diabetes patients randomly selected. RESULTS: The mean age was 55.4 years. The annual financial cost of managing one diabetes patient was estimated to be GH¢ 541.35 (US$ 373.34). Service cost constituted 22% whiles direct medical cost was 78%.  Drug cost was 71% of the financial cost. The cost of hospitalization per patient-day at Cocoa clinic was estimated at GHȼ 32.78 (US$ 22.61). The total financial cost of Diabetes management was estimated at GH¢ 420,087.67 (US$ 289,715.63). This accounted for 8% of the total expenditure for the Clinics in year 2009. The study showed that facility type, type of diabetes and presence of complications is associated with the cost of Diabetes management to Cocoa clinics. CONCLUSIONS: The cost of managing Diabetes Mellitus and accompanying complications can be used to forecast the economic burden of the disease to the clinics. The mean age indicates delay in diagnosing diabetes and accompanying complication which has cost implications. This calls for policies that will help in the early detection in clinical practice and effective management protocols by Cocoa clinics.      Keywords: Diabetes, financial cost, Cocoa clinics, complication, Cost-of-illness, Ghana.