OBJECTIVES: Postmortem audit is essential in health planning, interventions, disease prevention and control. Nigeria has the highest number of people living with Type 2 Diabetes Mellitus (T2DM) in sub-Saharan Africa. The study assessed the leading causes of death associated with T2DM to generate data for interventions and further studies. METHODS: A cross sectional descriptive survey was carried out to understand the mortality pattern among T2DM patients who were previously being managed and died in the hospital. Death register and the deceased patients medical records were used to extract data based on selected criteria. Only the medical records of dead T2DM patients who have visited the hospital for a minimum of 12 months following their diagnosis with T2DM were used for the study. The data of all eligible deceased T2DM patients who met the inclusion criteria was used.Data were analyzed with descriptive statistics. RESULTS: Overall, 58.0 (63.6%) female records were involved in the study (n=91). The highest death was recorded at the age range of 65– 85 years 55.0 (60.8%), followed by 46- 65 years 21.0 (23.5%). The disease duration from diagnosis to death ranged from >5 years 53.0 (58.8%). The number of years lived after the onset of T2DM was >10 years 40.0 (55.0%). Diabetic foot ulcer (DFU) was the co morbid condition with the modal score 9.0 (18%), followed by diabetic ketoacidosis (DKA) 6.0 (12%) and sepsis 6.0 (12%). The difference in proportion for co-morbid complications the between males and females was P=0.048. The p-value of P<0.05 was considered significant. CONCLUSIONS: T2DM co morbid with DFU, and DKA were the leading causes of death among T2DM patients in the facility. It suggests the need for interventions on better treatment practices in promoting diabetes care. Death was most prevalent among geriatric patients