Performance of diabetes self care behaviours is associated with improved glycaemic control, however patient adherence to self care recommendations is often suboptimal. At present, little is known about the self management practices of diabetic patients in Lesotho. The primary objective of this study was to assess self care behaviours of patients with type 2 diabetes. A cross-sectional, qualitative, interview-based study was conducted between April and May 2013; 55 patients were selected using convenience sampling. 87.27% of the patients had received diabetes self management education. Adherence to medication, diet, foot care, self monitoring of blood glucose and exercise was 74.54%, 58.18%, 50.91%, 16.36% and 12.73% respectively. The majority of the study participants had deficient knowledge about diabetes self-management. Interventions to increase patients’ self care behaviours in this setting should focus on improving diabetes self management education and support.