Background: With increasing prevalence of diabetes mellitus worldwide, primary health care physicians are the main providers of diabetes care and their knowledge, attitudes and practices are important to achieve goals in diabetes management. Objectives: Assessment of the knowledge, attitude and practices (KAP) of primary health care physicians regarding management of diabetes. To find-out gaps between the practices of primary health care physicians and the already established national and international guidelines. Methods: This cross- sectional study was conducted on 144 primary health care physicians working in a randomly chosen primary health care centers in Al Garbia Governorate. Data collected concerning knowledge, attitudes and practices of primary care physicians regarding diabetes management. Results: The study included 144 primary health care physicians working in 38 primary health care centers in Gharbia governorate. About two thirds (95) of the studied physicians were working in rural areas and the rest (49) in urban ones. As regards years since graduation, fifty three of the studied physicians were graduated <5 years and the rest (91) were graduated ≥5 years. Concerning relevant certifications or training courses, about three fourths (106) had relevant past experiences while one fourth (38) had no such experiences. Urban primary care physicians had higher percentage of correct knowledge than the rural ones as regards diagnosis, complications and managements of DM (p value <0.05). Primary care physicians with increased years of practice and who attended relevant training courses had favorable attitude and practices as regards counseling and regular examination of diabetic patients (p value <0.05). Conclusion: The current study revealed a shortage of knowledge, attitude and practices of primary health care physicians as regards management of diabetes. The defect in knowledge and unfavourability of attitude and inappropriateness of practices are obvious in family physicians working in the rural health care facilities, those without relevant experience and those graduated less 5 years.