Introduction. Diabetes mellitus is a chronic debilitating condition characterized by an increased blood glucose level and is associated with significant morbidity, mortality, and increasing health care cost. Diabetic foot ulcers and lower extremity amputations are a common, complex, costly, and disabling complication of diabetes. An estimated 15% of patients with diabetes develop a lower extremity ulcer. Objective. The aim of this study was to assess knowledge, practice, and barriers of diabetic foot self-care among diabetic patients attending Felege Hiwot Referral Hospital. Method. Institution based descriptive cross-sectional study was conducted on 313 diabetic patients using convenient sampling technique. Furthermore, descriptive statistics and binary and multivariate logistic regression were employed to assess the predicators of knowledge and practice of diabetic foot care. Result. Majority of respondents were males (64.9%). The mean age was 39.1 ± 16. The mean knowledge score was 7.5 ± 2.02 of which 56.2% and 43.8% had good and poor knowledge of foot care, respectively. The mean practice score was 25.2 ± 6.466 of which 53.0% had good and the remaining 47.0% had poor foot care practice. Of 162 respondents having barriers, 56.8% reported "poor communication between patients and health care providers, " 50.6% cited "I did not know what to do, " and 44.4% responded "inconveniency for work" as barriers of foot care. Conclusion and Recommendation. Knowledge and practice of foot care of diabetic patients are still substandard. Poor communication between patients and nurses/physicians, lack of adequate knowledge, and inconveniency for work were commonly cited barriers of foot care. Policy makers should initiate interventional foot care education program throughout the regional state. The study hospital should consider establishing a specialized diabetic clinic in which foot care education can easily be integrated into follow-up care.