Aim and Objective: To study the prescription patterns in patients receiving treatment for Type 2 Diabetes mellitus at a tertiary care teaching hospital by analysing the medication trends. Materials and Methods: A cross-sectional, observational study was conducted in a tertiary care teaching hospital with Institutional Ethics Committee approval. Data were systematically gathered from patient case files in the medicine wards, medicine outpatient department (OPD), diabetes OPD, and the dispensary, using a customdesigned proforma after obtaining necessary permissions. The study included patients diagnosed with type 2 Diabetes mellitus under treatment at the hospital. Results and Discussion: A study of 170 type 2 diabetes patients showed the predominant use of metformin, with glimepiride as the primary add-on for 96 patients. Other add-ons like glipizide, teneligliptin, and vildagliptin were used by one patient each. Six patients required triple therapy, typically combining teneligliptin, vildagliptin, or voglibose as second add-ons. Four patients were receiving insulin, but it was not included in the hospital formulary. The treatment approach largely depended on metformin and glimepiride. A cost-effectiveness analysis comparing glimepiride to dapagliflozin found an incremental cost of ₹73 per year for a reduction of 1 mmol/mol HbA1C with dapagliflozin. Conclusion: The study suggests a predominant reliance on Metformin and Glimepiride for the management of type 2 Diabetes Mellitus. The incremental cost-effective ratio (ICER) indicates that substituting Dapagliflozin as a second-line agent will increase yearly costs minimally for HbA1C improvements.