Diabetes is currently a crisis in sub-Saharan West Africa (SSWA) with dramatic implications for public health and national budgets prioritizing infectious diseases. There is limited recent literature about prevalence, awareness, and risk factors for type 2 diabetes (T2D) in rural parts of SSWA. This study aims to fill this gap through a field study in the rural Malian community of Nièna, which is situated in Mali’s second-largest province of Sikasso. From December 2020 to July 2021, a cross-sectional study of 412 participants was conducted in Nièna. Clinical questionnaires and rapid diagnostic tests were administered, and data were collected on patient demographics, anthropometric parameters, biochemical indexes tests, and diabetes awareness. Among 412 participants, there were 143 (34.7%) and 269 (65.3%) male and female participants, respectively. The overall prevalence of T2D was 7.8% (32/412), and prevalence rates were 8.9% (24/269) and 5.6% (8/143) for females and males, respectively. Family history of diabetes, hypertension, and fetal macrosomia were significantly associated with T2D (p < .001, p < .001, and p = .005, respectively). Notably, 62.5% (20/32) of T2D subjects were unaware of their diabetic status before the study. Among those previously diagnosed with T2D, only 29.4% (5/17) reported receiving routine care, treatment, or blood glucose control. This study suggests that diabetic unawareness and uncontrolled diabetes are disturbingly common. T2D would have devastating consequences in rural parts of Africa, where they often lack adequate resources, health care facilities, and qualified staff. Future studies are needed to determine whether the results presented here are generalizable to urban parts of Mali and, more broadly, to other parts of SSWA.