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Background Insulin pump therapy (IPT) improves glucose control in people with Type 1 diabetes (T1D) compared with multiple daily injections (MDI). However, their size, the tethered insulin infusion set, intrusiveness when operating the device, and the need to disconnect during showering limits their acceptance to many who may benefit. The Omnipod DASH® Insulin Management System is a small waterproof tubeless device worn on the upper arm which is wirelessly controlled by a handheld device which may be an acceptable alternative. However, there are no randomised controlled trials focusing on the impact on user perceptions of tubeless insulin pump therapy. This pilot study aims to assess the acceptability and feasibility of patch pump therapy compared with usual care in adults with T1D in Australia. Methods A pilot multi-site parallel randomised controlled study will be conducted in sixty-four adults with T1D who are managed on MDI or IPT and self-monitoring with finger-stick blood glucose from four specialist diabetes centres in Victoria, Australia. Following carbohydrate counting education, participants will be randomised to use Omnipod DASH® System (Omnipod group) or continue usual care (Usual care group) for 12 weeks, followed by a 12-week extension phase where all participants will use Omnipod DASH® System. The primary study outcome measures are acceptability which will be assessed by the difference in Diabetes Technology Questionnaire “current” (DTQ-current) score at 12 weeks post-randomisation compared to baseline, and feasibility which will be evaluated through study completion rates. Data on process outcomes, resource outcomes, participant centred outcomes, healthcare professional perceptions and glycaemic outcomes will also be collected. Discussion This pilot study will provide insights regarding feasibility of the study design and first data regarding user acceptance of insulin patch pump technology in Australian T1D adults. We anticipate that this study will provide information informing the design of a larger study evaluating the impact of patch pumps on subjective outcomes that are of significance to the person living with T1D. Trial registration: Australian New Zealand Clinical Trials Registry (https://anzctr.org.au/) ACTRN12621001195842 (8th September 2021) Protocol Version: V3.3; 17th June 2021. Authors (DNO and KK)