Background: tongue lesions are reflecting many systemic diseases of the body. Despite the relative frequency of Median Rhomboid Glossitis (MRG), its exact etiopathogenesis is controversial. A direct association between tongue lesions including MRG and oral candidiasis, tobacco smoking, denture wearing, and systemic conditions such as diabetes mellitus (DM) has been reported.

Objective: The objective of this present study was performed to determine the prevalence of MRG among Libyan diabetic and non-diabetic patients (NDPs), and hence detect and estimate the possible associations.

Method: The sample was made of 928 patients, divided into 2 groups. Group1 consist of 464 diabetic patients (DPs), while group 2 consists of 464 NDPs as a control group.

Results: the prevalence of MRG in all diabetic cases was (12%) whilst in NDPs was 3.4%. MRG was present in 56 DPs 39 (70%) were males and 17(30%) were females. There was a significant association between MRG and burning sensation P < 0.001.

Conclusion: MRG among Libyan patients was significantly more prevalent in DPs than in NDPs.