Background: Diabetes mellitus is a rising global health problem which requires continuous self-management practice to prevent acute and chronic complications. However, studies show that few diabetic patients practice the recommended self-management practices. This study aimed at assessing self-management practices among diabetic patients at Chilenje, Chawama and Kanyama First Level Hospitals in Lusaka, Zambia. Methodology: A hospital based cross-sectional analytical design was used for this study. The study population included all adult patients with diabetes mellitus who receive care at Chilenje, Chawama and Kanyama First Level Hospitals in Lusaka District. Fish bowl sampling without replacement was used to select participants and sample size calculated was 167. Data were collected using a structured interview guide adapted from the Summary of Diabetes Self-care Activities. Descriptive statistics and regression analysis were performed using the Statistical Package for Social Sciences v26.0 at 5% level of significance. Ethical clearance and permission to collect research data were sought and granted accordingly. Results: This study had a total 167 participants. Overall, the study observed that 122 (73%) patients reported poor self-management practices while only 45 (27%) reported good self-management. Unacceptable fasting glucose level ranges vs. acceptable fasting glucose level ranges (AOR: 0.38; 95% CI: 0.15, 0.99) p- value = 0.049 and 5 – 9 years with diabetes vs. less than 5 years and more than 9 years with diabetes (AOR: 0.36; 95% CI: 0.14, 0.95) p- value 0.039 were statistically significant predictors of poor self-management practices among diabetic patients. Conclusion: This study showed that majority of diabetic patients had poor self -management practices. The study further observed that patients with unacceptable fasting blood glucose level ranges and those with diabetes for 5 – 9 years were more likely to have poor self-management practices. ...