The clinical features of 44 episodes of diabetic ketoacidosis in 34 Ethiopians were similar to those reported from other nations. The mortality ws only 9.1%, even though serum potassium, bicarbonate and pH could not be measured. Although 3 patients were new diabetics, and the cause was not found in 7, most cases resulted from omission of insulin (43%) or intercurrent illness (28%). Socioeconomic factors, particularly the cost and unreliability of insulin supplies, are major obstacles to the control of diabetes and the prevention of ketoacidosis in Ethiopian patients.