Diabetes mellitus is a major global health concern, which has worse mental health outcomes such as suicide, however, suicide is one of the top public health priorities worldwide. The World Health Organization's objectives for suicide prevention emphasize the identification of high-risk groups especially people with comorbidity. This study aims to determine the prevalence of suicidal ideation and its associated factors among diabetic patients and correlate it with socio-demographic, lifestyle, and clinical characteristics. A cross-sectional study including diabetic Libyan patients attending diabetes outpatient clinic health centers in Tripoli, Libya from January to August 2024, using a questionnaire consisting of two parts. Part I contains data about the socio-demographic, lifestyle, and medical data and Part II uses a single item of the 9-item version of the Patient Health Questionnaire-9. Data was analyzed by Chi-square test, and logistic regression was used to identify factors. Odds ratio with 95% CI was used and variables with a p<0.05 in multivariable logistic regression were significant. A total of 395 participants was responding using systematic sampling, 62.8% of them where female, mean age of the patient was 52.98±9.30 years, 85.8% were non-smokers, mean duration of diabetic illness was 10.96±8.02, 59.0% insulin-dependent, 77.7% often committed to their drug, 61.8% had diabetes complication. The highest complication was in the eye 33.9%, 48.9% had comorbidity, 90.4% had no diet commitment, 21.8% had regular physical activity and 63.3% had difficulty to dealing ordinary life, and 26.8% of the patients had reported suicidal ideation. Female was 1.83 times (AOR=1.832 CI95%:1.26, 2.982) more likely to have suicidal ideation than males. The risk of suicidal ideation in age >50 years was 1.04 times that age ≤50 years (AOR=1.042 CI95%: 0.640, 1.698). The diabetic patients who used insulin therapy, the odds of risk higher than participants who used oral antidiabetic was 1.34 times (AOR=1.345 CI95%: 0.849, 2.131). The odds of having suicidal ideation among participants with poor glycemic control was 3.60 times higher when compared with good control diabetes participants (AOR=3.614 CI95%: 1.924, 6.783). The prevalence of suicidal ideation was 26.8% in type II diabetic patients attending Primary Healthcare Centers. There was a significant association between suicidal ideation and female gender, age, and poor glycemic control.