To evaluate the effectiveness and safety of pioglitazone combination therapy in patients with type 2 diabetes. A retrospective multi-centric study was conducted in adult type 2 diabetic patients on pioglitazone combination therapy across seven centres. Percentage of patients achieving glycemic control (HbA1C level < 7%) with pioglitazone combination therapy was the primary efficacy endpoint. Safety was evaluated by recording adverse events. 602 patients (58.0 % male; 42 % female) with mean age of 56.0 (+10.65) were enrolled in the study. Family history of diabetes was present in 41.5 %patients. Pioglitazone was commonly prescribed in combination with metformin and glimepiride (24.8%).The mean duration of pioglitazone combination therapy was 3.36 (+2.29) years. Comorbid conditions such as hypertension and dyslipidemia were present in 48.7% and 48.5% patients respectively in this study. Proportion of patients with HbA1c ≥7% decreased from 85.2% to 53.5% after pioglitazone therapy. 1.6% reduction in mean HbA1c was observed after pioglitazone therapy (8.8% to 7.2%). Reduction in mean fasting plasma glucose and postprandial plasma glucose was 45.2 mg/dl (169.5 mg/dl to 124.3 mg/dl) and 61.5 mg/dl (246.8 mg/dl to 185.3 mg/dl) respectively, after pioglitazone therapy.. There was no safety events observed with the use of pioglitazone based therapies. Pioglitazone combination therapy is found to be effective and safe in adult type 2 diabetes Indian patients.