<i>Background</i>: Type 2 diabetes mellitus (T2DM) is a major contributing factor to osteoporotic fractures via different mechanisms. This study assessed the ten-year risk of osteoporosis and associated factors for osteoporotic fractures in T2DM patients. <i>Methods</i>: Data from 175 type diabetes mellites (T2DM) patients over 40 years attending a diabetes clinic at Tikur Anbessa Specialized Hospital (TASH) were collected. Demographic information, diabetic complications, blood sugar levels, and other medical illnesses were collected by a structured questionnaire and from an electronic medical record system. The 10-year fracture risk assessment (FRAX) tool was used without bone mineral density (BMD) measurement. multivariate logistic regression was used to analyze factors associated with fragility fractures. <i>Results</i>: Half the participants were female, with a median age of 60. Most were married, well-educated, and urban residents. The median duration of diabetes was 11 years. The median FRAX score indicated a moderate 10-year risk of hip fracture (≥3%) and a high risk of major osteoporotic fracture (≥20%). Overall, 30.9% of patients had a high 10-year risk of osteoporotic fracture. The majority (78.3%) had macrovascular complications, with neuropathy, retinopathy, and nephropathy being the common ones. Higher FBS, higher HbA1c, and the presence of macrovascular complications were significantly associated with a higher risk of fractures. <i>Conclusion</i>: This study found a high prevalence (30.9%) of a 10-year risk of osteoporotic fractures in T2 DM patients. Poor glycemic control (higher HbA1c and FBS) and the presence of macrovascular complications were significantly associated with an increased 10-year osteoporotic fracture risk.