Introduction: The global progression of diabetes mellitus (DM) pandemic is a real public health problem. This growth, more remarkable in low- and middle-income countries is linked to risk factors (RF) and urbanization. This study contributes to the updating of epidemiological data on diabetes and its RF in rural and urban areas in Congo. Aim of the Study: To describe epidemiological and diagnostic aspects of DM and its RF in rural and urban areas in Congo. Patients and Method: A cross-sectional, retrospective and multicenter study, including patients in 20 centers (urban/rural) from October 2010 to 2017.Studied parameters were: socio-demographic profile, duration of diabetes, anthropometric measurements, RF, types of DM and glycaemia. Data were analyzed by Epi info 7.2.1.0, using Chi-2 and Student, with a significance threshold of 0.05. Results: A total of 4758 patients were received, including 4116 patients (86.51%) in urban areas and 642 patients (13.49%) in rural areas. Among them, 2460 men (51.70%) and 2298 women (48.30%), M/F ratio of 1.07. The mean age was 51.67±15.45 years [range 2 to 95 years].3021 patients (63.5%) were known to be diabetic, with a mean duration of 5.97 years and 1737 patients (36.5%) were newly diagnosed. The annual incidence was 248 new cases/year. The socio-professional status was dominated by the unemployed (33.80%), employees (26.2%), students/pupils (12.9%) and retirees (11.9%). T2D (84.72%) and T1D (8.53%) were more represented. RF: Hypertension (39.34%), affects 90.60% of patients in urban areas and 9.40% in rural areas (p = 0.000). Overweight (37.89%) and obesity (27.77%), predominantly urban, female and in T2D (p = 0.000)). Metabolic syndrome of urban predominance was found in 17.12% of patients. The mean glycaemia was 283 ± 14 mg /dl. Conclusion: Our study shows that DM and its RFs are common in Congo, with a strong predominance in urban areas, requiring specific strategies to reduce the impact of urbanization.