Introduction: Diabetes mellitus is a significant global health concern, with an increasing prevalence worldwide. One of the most severe complications of diabetes is lower limb amputation, which has devastating physical, psychological, and socioeconomic consequences for patients. Understanding the frequency and associated factors of lower limb amputation among diabetic patients is crucial for developing targeted prevention and management strategies. Methods: A quantitative observational cross-sectional study was conducted to determine the frequency of lower limb amputation and associated factors among 300 diabetic patients in three selected hospitals in Mogadishu, Somalia from July 2022–November 2023. Demographic characteristics, clinical data, and amputation-related information were collected through patient interviews and medical record reviews. Results: The study found that 57% of the participants were male, and the majority (50%) were aged 41-65 years. The main reasons for amputation were diabetic foot ulcers (67%) and peripheral arterial disease (33%). The overall frequency of lower limb amputation was 35%. Factors associated with amputation included older age, male gender, longer duration of diabetes, poor glycemic control, and the presence of diabetic complications like neuropathy and peripheral arterial disease. Discussion: The high frequency of lower limb amputation among diabetic patients in this study highlights the need for a multifaceted approach to diabetes management, including early detection and prevention of complications, prompt wound care, and a multidisciplinary team-based approach. Rehabilitation and psychosocial support are also crucial to improve the quality of life for amputees.