Objective: The aim of this study was to estimate the incidence of diabetic ketoacidosis and the mortality rate at Benghazi city. Methods: A cross-sectional study of the records of all patients admitted with diabetic ketoacidosis to all Benghazi hospitals (governmental and private) between 1st of January and 31st of December 2007. Results: The annual incidence of diabetic ketoacidosis was 41.7 episodes/100,000 populations with a mean age of 33±20.1 years (2-93). Around 52% of all the episodes occurred in males and 2.6% of adult Diabetic ketoacidosis occurred in pregnant females. Type-2 diabetics were responsible for 27.7% of all episodes. The commonest precipitating factor in the whole study group was dose disruption (35%), followed by infection (20%). The most common presenting symptoms were gastrointestinal, whilst 3.5% of the patients were comatose at presentation. The overall mortality was 11.7% and there was no significant difference in mortality between males and females (11% vs. 12.6%; p=0.6); however, type-2 diabetics showed a significantly higher mortality rate (29.3% vs. 4.9%; p=0.000). Conclusion: Diabetic ketoacidosis is a common condition in Libya with a high mortality rate and type-2 diabetics constitute a considerable number of the cases.