AIM:: The aim of this study was to explore barriers to and facilitators of diabetes self-management among first-generation Korean-American elderly immigrants with type 2 diabetes in the United States Midwest. BACKGROUND:: The number of Korean-American elderly immigrants with type 2 diabetes in the United States is expected to increase because they are at risk of adopting a Western lifestyle. METHODS:: Three focus groups (N = 18) and five individual interviews were conducted with Korean-American elderly immigrants with type 2 diabetes. Demographic characteristics and diabetes-related medical history information were obtained with a questionnaire. All data were digitally recorded, transcribed verbatim and translated from Korean into English. Transcripts were analysed using standard content-based analysis. RESULTS:: Five perceived barriers were identified: the high cost of type 2 diabetes care, language issues, loss of self-control, memory loss and limited access to healthcare resources. Three perceived facilitators were time, seeking information, and family and peer supports. LIMITATIONS:: The convenience samples and small sample size may limit the study. CONCLUSIONS:: The barriers to and facilitators of diabetes self-management identified in this study can be used in the development of more age- and culturally sensitive diabetes interventions and resources. IMPLICATION FOR NURSING AND HEALTH POLICY:: Nurses and healthcare providers can use this studyʼs findings to develop patient-centred, age-appropriate and culturally appropriate diabetes interventions. There are urgent needs to train bilingual healthcare providers and staff and to provide translation services for Korean-American elderly immigrants. Finally, communities and social supports within public health policy are urgently needed for this ethnic minority group.