Aims: To replicate, in Zambia, a recent global study by the WHO, which reported that the odds of depression were not increased in African people with diabetes, and to explore the sociodemographic and clinical factors associated with depression. Methods: A total of 773 control subjects and 157 Zambian patients with diabetes completed the Major Depression Inventory and a list of demographic indicators. Results: Compared with control subjects (mean ± sd Major Depression Inventory score 15.10 ± 9.19), depressive symptoms were significantly more common in patients with diabetes (mean ± sd Major Depression Inventory score 19.12 ± 8.95; P < 0.001). ancova showed that having diabetes [F(1,698) = 16.50, P < 0.001], being female [F(1,698) = 7.35, P < 0.01] and having low socio-economic status (F(1,698) = 13.35, P < 0.001) were positive predictors of depression. Conclusions: Contrary to the WHO study, we found that depression was a common comorbid health problem among Zambian people with diabetes. Clinicians should consider patients' health status, sex and socio-economic status as potential factors predicting depression.