Background: Type 2 Diabetes Mellitus (T2DM) is a serious issue in Egypt, with severe consequences for individuals, families, and governments. Illness perception in diabetes patients is critical in determining their health outcomes, particularly in glycemic management, and hence must be assessed and understood in order to optimize their health and quality of life. Objective: The current study aimed to improve the quality of life of T2DM patients through assessing their illness perception and identifying its associated factors. Patients and methods: A cross-sectional was conducted on 157 T2DM Egyptian patients, between August 2021 and June 2022, at the outpatient clinic of Zagazig University Hospitals. Data on demographic and clinical history were collected using a structured Arabic questionnaire. Socioeconomic status and illness perception, using the brief illness perception questionnaire (BIPQ), were assessed. Results: Most participants had negative illness perceptions (52.2%). There was a statistically significant difference between participants with good and poor glycemic control in perceptions of consequences (P<0.001), personal control (P= 0.013), and identity (P= 0.012), as well as overall score of illness perception (P=0.006). There was a statistically significant difference between participants with negative and positive illness perceptions in sex (P=0.001), socioeconomic status (P=0.012), type of medications (P<0.001), HbA1c (P=0.008), having a glucometer at home (P<0.001), and previous hospitalization due to diabetes-related complications (P<0.001). Conclusion: T2DM patients suffer negative illness perceptions, especially those with poor glycemic control. Physicians need to take these perceptions into account, and interventions should be implemented to modify these perceptions with the purpose of positively affecting glycemic control.