Background and aims: Glycemic control among patients with diabetes mellitus is associated with a marked reduction of both macrovascular and microvascular complications; however, glycemic control remains an elusive goal worldwide. The aim of this study was to determine factors associated with glycemic control among patients attending a tertiary clinic in Botswana as limited information to date. Methods: Cross-sectional study in a tertiary clinic in Gaborone, Botswana. Patients were recruited between 21 st July 2015 and 21 st September 2015. The majority of the randomly recruited patients (368/380-96.8%) had documentation of glycemic control (HbA1c) within three months of study recruitment and were subsequently included in the analysis. Glycemic control was categorized as desirable, suboptimal and poor if HbA1c was < 7%, 7-9% and > 9% respectively. Data was analyzed using SPSS for descriptive statistics including both bivariate and multinomial logistic regression. Ap-value < 0.05 was considered statistically significant. Results: The analyzed study population consisted of 258/368 (70.1%) females with a mean age (SD) of 56.7± 13.6 years. Means (SDs) for diabetes duration and glycated haemoglobin were 7.2± 7.1 years and 7.97± 2.02% respectively. Of the 368 patients, 136 (36.95%) and 132/368 (35.86%) had desirableand suboptimal glycemic control respectively. Older age, attending the clinic for more or equal to 3 years and not being on insulin were associated with both desirable and suboptimal glycemic control whereas duration of diabetes between 5-10 years was associated with poor glycemic control. Conclusions: The majority of patients had poor glycemic control. Older age and not being on insulin were associated with better glycemic control. The fact that patients on insulin had poor glycemic control calls for more research to determine timing of insulin initiations and dosing schedule factors as these will help toimprove overall glycaemic control in Botswana and elsewhere.