Background and aim: Diabetes is one of the leading non-communicable diseases in the world; diabetes is common in the elderly. The aim of this study is to assess the prevalence, clinical features and complications of type 2 diabetes mellitus among the elderly in the Hôpital Provincial du Nord-Kivu in Goma. Subjects and Methods: A cross sectional study was based on data collected among the elderly from 2013 to 2015 in the Department of Internal Medicine. Overall, 418 elders were included. Results: The prevalence of type 2 diabetes mellitus was 8.6% (95% CI: 6.3 -11.7). Overall, 54% of the elderly were males while 46% were females. Among males, 6.6% were diagnosed with diabetes whereas 11.0% were among females (p < 0.001). All elderly diabetic subjects (n = 36) were taking anti diabetic drugs such as insulin or oral medications (sulfonylurea and/or biguanide). Among those, 15 (41.7%) were on insulin and 21 (58.3%) on oral anti diabetic. Mean fasting glucose was higher among elderly individuals taking oral medications compared with their counterparts on insulin (104.4 versus 157.3 mg/dl, p < 0.001). The asthenia (86.1%), the polyuria (13.9%), the coma (11.1%) and the polydipsia (5.6%) were the principal symptoms on admission. The infectious, metabolic, micro vascular and macrovascular complications were diagnosed in this study. Conclusion: Our study provides evidence on the high prevalence of type 2 diabetes mellitus among elderly individuals. Moreover, the study found many factors associated with type 2 diabetes mellitus among the elderly and the difficulty of diagnosing diabetes in the elderly. Hence, there is need to enhance the existing prevention programmes with emphasis on social determinants of diabetes, which need to be clarified by broad epidemiological studies at the population level.