The aim of the study was to observe and analyze the prescribing pattern of anti diabetic drugs in medicine ward. This study was a descriptive cross sectional study/ prospective observation study. The study was conducted at Rajah Muthiah Medical College Hospital (RMMCH), Annamalai University, Chidambaram, a 1250 bedded multi specialty tertiary care University teaching hospital located in rural India. Analyze the prescription as per the WHO Prescribing Indicators. The following are the parameters: Prescribing indicator, Patient care indicator and Facility indicator. A prescribing practices measure the performance of health care providers in several key dimensions related to the appropriate use of drugs. The indicators are based on the practices observed in a sample of clinical encounters taking place at outpatient health facilities for the treatment of acute or chronic illness. A total of 1232 drug products were prescribed. Thus, the average number of drugs per prescription or mean was 4.83. The total number of drugs prescribed by generic name was 40.01% (493 drugs), 32.46% drugs prescribed with diabetic medication and 67.54% of drugs prescribed with the management of co morbidity diseases conditions, 17.04% of prescription containing injections that include insulin, antibiotics, GIT and some vitamins. Almost all drugs (58.76%) prescribed from Tamilnadu EDL, as well as RMMCH drug list. Drugs prescribed from an Essential Drug List (EDL) were 74.30%. Since Insulin can be administered only by subcutaneous route, % of injections (17.04%) comprise only of insulin injection. Among the 255 patients the average consultation time with prescribe was 8.40 minute and the average dispensing time in medical store was 7.2 minute. About 30.58% patients have good knowledge about the correct dosage of each tablet. Present study shows that the majority of diabetes patients were in the age group of 40 -60 years. Resulting in the development of diabetic related complications in most productive years of life, as compared to western studies were mean age is around 60 years, Prescription pattern analysis showed that most of the patients were on combination therapy 51.37% and followed by monotherapy 48.62%, Commonest drugs used in monotherapy were sulfonylureas, Insulin and metformin. The commonest two drug combinations were sulfonylureas with metfomin. There are no overall changes in prescription pattern by the physicians during the three year study period