OBJECTIVES: Poor glycemic control is major public concern and potential contributor for the development of diabetes related complications. Various factors have been found to be associated with poor glycemic control. Identification of these factors is important in order to formulate appropriate interventions to reduce risks of diabetic related complications and deaths. This study aimed to assess the magnitude and the factors associated with poor glycemic control among type II diabetic patients at Northwest General Hospital and Research centre, Peshawar.METHODS: Hospital based cross-sectional study was conducted on 418 type II diabetic patients. The questionnaire extracted information regarding patients ‘self-management behaviours, socio-demographics and clinical characteristics. Additionally data collection including biochemical estimations were extracted from patients medical records. Poor glycemic control was defined as HbA1c >7%. Significance testing of proportions was carried out by using student t-test, chi-square test or Fischer exact test where appropriate. Odd ratios along with 95% CI and p-value was calculated using logistic regression to study the independent factors predicting poor glycemic control. RESULTS: The mean age of patients was 53.54±11.05 years. Majority 245 (58.6%) of patients were females. Out of 418 patients, 337(80.6%) were classified as poor controlled regarding glycemic level. The factors which are significantly associated with poor glycemic control were high blood pressure (AOR=0.520 95%CI: 0.283-0.954) Being urban resident (AOR=1.929 95%CI: 1.020-3.654) having high level of low density lipoproteins (AOR=0.386 95%CI: 0.178-0.836), low adherence to healthy diet (<2days/week) (AOR=2.926 95%CI: 1.381-6.198) and low medication adherence (AOR 0.159 95%CI: 0.066-0.380). CONCLUSIONS: A significant proportion of patient’s had poor glycemic control. Residence, high blood pressure, high level of low density lipoproteins, low adherence to healthy diet and low medication adherence were associated with poor glycemic control. An education program should be developed to educate patients on the importance of medication adherence and self-care management for better glycemic control.