This study aims to assess the length of stay and cost per hypoglycemia episode, as well as to determine the factors that influence the length of stay, intensive care unit (ICU) admission, and hospitalization costs among patients with diabetes mellitus. This is a retrospective cross-sectional study conducted on a cohort of diabetic individuals who experienced confirmed hypoglycemia episodes. The data pertaining to these patients were obtained from their respective hospital medical records, covering the period from January 2021 to December 2022. King Fahd Medical City was selected as the site of data collection for this study. A total of 396 patients were involved in this study. The median duration of stay for the patients was 7.0 (2.0-16.0) days. Only 3.0% of the patients had a previous hypoglycemia admission history. Around 53.3% of the patients were admitted to the ICU. The median duration of ICU admission stay was 1.0 (0.0-1.0) days. The highest cost driver for patients with hypoglycemia was ICU stay with a median cost of 9000.0 (1125.0-15750.0) Saudi Arabia riyal (SAR) (2399.6 (300.0-4199.2) United States dollar (USD)). The total median cost associated with hypoglycemia hospitalization was 4696.0 (886.5-12789.5) SAR (1252.0 (236.4-3410.0) USD). Ex-smokers were more likely to have higher hospitalization costs for hypoglycemia (4.4-folds) (P <
.001). Being admitted to the ICU increased the likelihood of having a longer length of hospitalization by 2.6-folds (P <
.001). Patients with longer diabetes duration (above 9 years) were more likely to be admitted to the ICU by 2.9-folds (P = .008). Understanding the factors that affect hypoglycemia hospitalization cost and length is essential for improving diabetes care and resource usage. Identifying high-risk patients and implementing efficient preventative strategies can lower the economic burden of DM and accompanying hypoglycemic episodes and enhance DM management.