Background: Diabetes is a major public health problem all over the world. In India, the prevalence of Type 2 diabetes is higher in Kerala. Since there is lack of population based studies in the Malappuram district of Kerala, the study aimed to find out the prevalence of type 2 diabetes and its risk factors in Malappuram. Methods: A cross sectional study was conducted among 798 adults in the age group of 25 to 75 years. Information on their socio demographic, physical, bio chemical and behavioural characteristics, family history of diabetes was collected using the pre tested interview schedule. All known cases of type 2 diabetes and those with Fasting Blood Sugar level>125mg/dl were considered as diabetic. The prevalence of type 2 diabetes and pre diabetes were estimated and their risk factors were statistically analysed. Results: The prevalence of type 2 diabetes among the study participants was 22.4 percent. The significant risk factors of diabetes found among the adults studied were age, family history of diabetes, both generalized and central obesity, tobacco chewing and hypertension (p<0.05). Among them, advancing age, family history of diabetes, central obesity and hypertension were the major predictors of type 2 diabetes in the study population (p<0.001). Conclusion: High prevalence of diabetes was observed in the study area. Central obesity and hypertension were the major risk factors to be modified in the study population through sustainable and effective lifestyle changes.