ABSTRACT: BACKGROUND:Diabetes, a rising global health problem, requires continuous self-care practice to prevent acute and chronic complications. However, studies show that few diabetes patients practice the recommended self-care in Ethiopia. The aim of this study was to assess factors associated with self-care practice among adult diabetes patients in public hospitals of West Shoa Zone, Oromia Regional State, Ethiopia. METHODS:In this cross-sectional study, 257 diabetes patients (mean age 42.9?±?14.6 years, 54.1% male) completed the survey in Afan Oromo and Amharic languages. A questionnaire consisting standardized tools was used to collect the data. Descriptive and logistic regression analyses were conducted using SPSS version 21. RESULTS:The mean score for diabetes self-care was 39.8?±?9.5 and 45.5% of the participants scored below the mean. Multiple logistic regression analysis revealed that having higher diabetes knowledge (AOR?=?2.42, 95% CI?=?1.22, 4.80), self-efficacy (AOR?=?3.30, 95% CI?=?1.64, 6.62), social support (AOR?=?2.86, 95% CI?=?1.37, 5.96), secondary school education (AOR?=?6.0, 95% CI?=?1.90, 18.85), and longer duration of diabetes (AOR?=?5.55, 95% CI?=?2.29, 13.44) were important predictors of good diabetes self-care practice. CONCLUSION:The diabetes education programs should use strategies that enhance patients' diabetes knowledge, self-efficacy, and social support. Patients with recent diabetes diagnosis need special attention as they may relatively lack knowledge and skills in self-care. Further studies are needed to elucidate pathways through which diabetes knowledge, self-efficacy, social support, and health literacy affect diabetes self-care.