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OBJECTIVE—To develop and test a patient questionnaire on treatment satisfaction with diabetes regimens. RESEARCH DESIGN AND METHODS—Survey items were developed from community clinic focus groups, pretested in patients with diabetes, and examined in two samples of treated patients. RESULTS—Sixteen items performed well in assessing treatment experiences: ease and convenience, lifestyle burdens, well-being, and medical control. Construct validity was supported by associations (P < 0.05) with treatment complexity, self-rated glucose control, health worries, and A1C. Internal consistency ranged from 0.89 to 0.95. CONCLUSIONS—The Diabetes Medication Satisfaction Tool offers a comprehensive assessment of patient acceptability, with diabetes therapy useful for individualizing therapeutic decision making.