Background: Diabetes mellitus (DM) is a major health problem that is associated with psychological, as well as physical, complications particularly depression. Depression is well-known to be prevalent among diabetic patients and to be associated with poor glycemic control, poor adherence to medication, increased diabetic complication and higher risk of mortality. Objectives: The purpose of the study is to determine the prevalence rate of depression among diabetic patients in primary health care units and diabetic centers at Makkah city – Saudi Arabia, and to explore the associated factors that co-exist with depression among diabetic patients. Methods: This was a descriptive cross-sectional study conducted on 382 diabetic patients (both type I and II) recruited from diabetic centers at Al-Noor hospital, Hera'a hospital, and East of Al-aziziah hospital in Makkah, KSA. Data were collected via a self-administered questionnaire including demographic variables and the Arabic translation of Patient health questionnaire the Tunisian version (PHQ-9). The data collected were analyzed using SAS 9.4. Results: After data analysis of the 382 participants 43.19% were males and 56.81% were females, with a mean age of 50.28±11.43 years. The prevalence of depression was 20.68%, with 12.83%, 7.07%, and 0.79% having moderate, moderately severe, and severe depression, respectively. Hypertension, duration of hypertension, number of co-morbidities, and high education level were significantly associated with depression (p=0.0111, 0.0029, 0.0491, and 0.0158, respectively).  The odd's ratio of number of co-morbidities was 1.565 (p=0.0039). Conclusions:  Depression and suicidality are prevalent among diabetic patients in Makkah.  When diabetes co-exists with hypertension and/or other comorbid illnesses the prevalent doubles. Hypertension, increased number of associated co-morbidities, and high educational level are significantly associated with depression in diabetic patients.