Khat chewing is associated with lifestyles and dietary habits that have a direct link to the increase of blood glucose levels. The present study aimed to assess the prevalence and associated risk factors of pre-diabetes and diabetes among khat chewers in Bahir Dar. In this cross-sectional study, 265 khat chewers were selected using snowball sampling. The association and strength of association between DM and risk factors were determined using univariate and multivariable logistic regressions in SPSS version 25. The prevalence of pre-diabetes and diabetes mellitus was 21.1% and 14.0%, respectively. DM was associated with being married, being widowed, chewing khat for 5 to 10 years, chewing 51 to 100 grams of khat per chewing session, medical history of hypertension, sitting for ≥ 3 hours a day for chewing, and having high waist circumference (p < 0.05). The independent predictors of DM in this study were khat chewing frequency of 5 to 7 days a week (AOR = 6.322) and chewing ≥ 100g khat per chewing session (AOR = 4.721). Khat chewers in Bahir Dar show higher diabetes rates than national averages. Key risk factors include frequent, high-quantity khat use. Reducing consumption can lower risk.