Background: Tropical diabetic hand syndrome (TDHS) is a known complication affecting patients with diabetes mellitus in the tropics. However, there has been no previous report on the condition from the Northern Nigeria. This study assessed the prevalence of the syndrome among diabetic patients attending the endocrine clinic of Ahmadu Bello University Teaching Hospital (ABUTH), North Central Nigeria. Materials and Methods: A retrospective cohort study was employed for the study from January 2010 to May 2013. All patients with incomplete treatment records were excluded from the study. Data analysis was done with Statistical Packages for Social Sciences (SPSS) version 20.0 and presented as tables and charts. Results: Of the total 894 cases reviewed, the prevalence of diseases condition was 12 (1.3%), with female to male ratio of 2:1. Majority (75.0%) of the initiating events were minor trauma, followed by spontaneous blisters and subsequent rupture (16.7%) and the least (8.3%) was burns. The mean interval between onset of disease and presentation in the hospital was 22.9 days. Staphylococcus aureus was the main microbial isolates (75.0%) and majority (88.9%) were sensitive to ciprofloxacin. Mortality rate among the patients was 25.0% while amputation and healing with fixed flexion deformity of digits accounted for 33.3% and 58.3%, respectively. Conclusion: TDHS is a significant complication among diabetic patients in ABUTH, and the most common initiating risk factor was minor trauma. Mortality rate among the patients was also high. Hence, there is a need for intensive education of diabetic patients on the benefits of early diagnosis and treatment and avoidance of trauma.