<p><strong><em>Background</em></strong><strong>: </strong>Diabetes mellitus (DM) is a chronic metabolic disorder characterized by high blood sugar levels that has been escalating globally at an alarming rate. Despite the growing concern, there has been a paucity of data on the incidence of diabetes in Ethiopia, particularly in the Awi Zone. A timely data analysis and synthesis is crucial for designing effective interventions and formulating policies to address this emerging health crisis. Therefore, this study aimed to assess the epidemiology and trends of diabetes using four years of surveillance data on diabetes patients in the Awi Zone, Northwest Ethiopia.</p>