Background: The incidence of type 2 diabetes in patients below the age of 40 (early onset diabetes) is markedly on the rise and has been linked increased prevalence of risk factors such as the metabolic syndrome and family history of diabetes. Objective: To determine the proportion of patients with type 2 diabetes at Aga Khan University Hospital Nairobi (AKUHN) who have early onset type 2 diabetes and the association of age of onset with risk factors (family history of diabetes, obesity, waist circumference, hypertension, low HDL cholesterol and hypertriglyceridaemia) in this group of patients. Methods: This was a cross sectional study. All adult patients with type 2 diabetes presenting to the AKUHN diabetic clinic from 1 February to 30 April 2012 who consented to participate were included. A data collection form was completed documenting patient demographics, anthropometric measurements and fasting lipid profile. Results: A total of 140 patients were recruited. Males comprised 59.3%. Mean age at diagnosis was 48.1 years. The proportion of patients with early onset Diabetes was 24% (95%CI 17%-31%). Patients with early onset diabetes were more likely to have a relative with diabetes compared to the usual onset group (OR 3.58; p< 0.009). There was a positive association with early onset diabetes and having a first degree relative with diabetes (OR 3.92; P<0.007) and having two relatives with diabetes (OR 5.11; P<0.017). Patients with early onset diabetes were more likely to have hypertriglyceridaemia (OR 1.82; p<0.187). This study did not find a positive association with early onset of diabetes and abdominal obesity (OR 0.74; P<0.600), hypertension (OR 0.3; P<0.004), abnormal BMI (OR 0.61; P<0.448) or low HDl-Cholesterol (OR 1.01; P<0.982). Conclusion: There is a high proportion of early onset type 2 diabetes in this study population which was associated with having a family history of diabetes, a first degree relative with diabetes and more than one diabetic relative.