To study the prescribing pattern and adverse drug reactions (ADRs) of anti-diabetic drugs in a tertiary care hospital in Lucknow, India. Methods: A prospective study was conducted over a period of 6 months at the inpatient and outpatient departments of the hospital. A total of 100 patients with diabetes were included in our study. Demographic characteristics were recorded and 100 prescriptions were analyzed. ADRs were reported and analyzed. Results: Among the 100 patients, 58 were male and 42 were female. The majority of the patients were in the age group of 41-60 years. Biguanides (38%) and sulphonylureas (31%) were the most commonly prescribed anti-diabetic drugs. A total of 8 ADRs were reported, including hypoglycemia, gastric irritation, and abdominal discomfort. Metformin had the highest number of ADRs among the oral hypoglycemic drugs. Conclusion: The study showed that the prescribing pattern of anti-diabetic drugs in the hospital was in line with the essential medicine list. ADRs were reported, with hypoglycemia being the most common ADR observed. Continuous monitoring and reporting of ADRs is necessary for the safe and effective use of anti-diabetic drugs.