The World Health Organization (WHO) has reported that Saudi Arabia ranks the second highest in the Middle East, and is seventh in the world for the rate of diabetes. It is estimated that around 7 million of the population are diabetic and almost around 3 million have pre-diabetes. Even more worrying perhaps, is the increasing pattern of diabetes noted in Saudi Arabia in the recent past. In fact, diabetes has approximately registered a ten-fold increase in the past three eras in Saudi Arabia. Diabetes mellitus (DM) has been found to be related to high mortality, morbidity and vascular complications, accompanied by poor general health and lower quality of life. In Saudi Arabia, DM is quickly reaching disturbing proportions and becoming a significant cause of medical complications and even death. However, when compared with the developed countries, the research work conducted, focusing particularly on the incidence, prevalence and socio-demographic properties of DM is woefully inadequate. The health burden due to DM in Saudi Arabia is predicted to rise to catastrophic levels, unless a wide-ranging epidemic control program is incorporated, with great emphasis laid on advocating a healthy diet, including exercise and active lifestyles, and weight control. To properly manage the DM in Saudi Arabia, a multidisciplinary approach is required. In this review we discuss all the aspects of DM in Saudi Arabia drawing from the published literature currently available.