Objective. To determine the prevalence of diabetes and its associated risk factors in elderly coloured South Africans. Research design. Cross-sectional analytical study. Methods. A random sample of 200 non-institutionalised coloured (mixed ancestry) subjects aged ≥ 65 years of age, resident in urban Cape Town, was drawn by means of a two-stage cluster design. The survey procedure included an oral glucose tolerance test, anthropometric measurements, and physical activity and alcohol intake assessments. Results. The prevalence of diabetes was 28.7% (95% CI 21.7-35.7%), 25.7% in men and 30.3% in women. The prevalence of impaired glucose tolerance was 15% (95% CI 9.2 - 20.8%). Upper-segment fat distribution (P < 0.001) and body mass (P < 0.05) were identified as significant risk factors for diabetes. A differential age and sex interaction was evident; in men the association between the identified risk factors and diabetes increased with age, while in women the association was strongest in those aged < 70 years. Body mass index, alcohol intake and physical activity were not significant risk factors. Conclusions. The prevalence of diabetes in older coloured South Africans was found to be high. The predicted increase in the proportion of the coloured population aged 65 years and older during the next 4 decades has important implications for the allocation of health resources for management of chronic diseases associated with ageing; diabetes appears to constitute a major health problem in this regard.