Introduction Type 2 diabetes mellitus (T2DM) is inherited genetically. There may be an association with blood group as blood group is predetermined genetically Genetic background thus has a role in the pathogenesis of type 2 diabetes mellitus, although environmental factors playing a big role in the final outcome If the increased prevalence with a particular ABO phenotype is confirmed, preventive strategies can be adopted in those persons. Our study was therefore undertaken considering these conflicting findings Material and Methods A comparative cross-sectional study was conducted among T2DM patients and healthy controls. The study was conducted at Department of Physiology, Shadan Institute of Medical Sciences Teaching Hospital & Research Center. All T2DM patients who attended Hospital were the source population for cases while healthy volunteer blood donors at blood bank were the source population for controls. The study population for cases was all T2DM patients who had medical follow-up at Hospital during the data collection period, whereas healthy (non-diabetic) voluntary blood donors who donated blood during the study period at the Hospital blood bank were considered as the study population for controls. During data collection, the identification of T2DM from T1DM was done by analyzing the patient chart. Results Distribution of Blood Groups Among the study population (n=260), blood group B had the highest frequency (30.8%), followed by A (26.9%), O (23.1%), and AB (19.2%). T2DM Prevalence Blood groups A and B showed higher prevalence rates of T2DM (64.3% and 62.5%, respectively) compared to AB (40.0%) and O (50.0%). Statistical Significance Blood group A showed a statistically significant association with T2DM (OR=1.50, p=0.042). Blood group B showed a higher odds ratio but did not reach statistical significance (p=0.078). Blood group AB showed no significant correlation, and blood group O served as the reference group. Conclusion The study suggests a potential correlation between ABO blood group and the prevalence of T2DM, with blood group A showing a statistically significant association. Blood group B also exhibited a notable trend, though not statistically significant. These findings highlight the importance of considering genetic and lifestyle factors in T2DM risk assessment. Further studies with larger and more diverse populations are recommended to validate these results and explore underlying mechanisms