Background <p>Asymptomatic bacteriuria (ASB) is more widespread in postmenopausal women, especially among diabetic women. Nevertheless, a comprehensive definition of independent predictors of ASB in the general postmenopausal population and in the high-risk diabetic subgroup remains critical for management strategies.</p> Methods <p>The study was a cross-sectional examination of the prevalence of ASB and risk factors among 400 postmenopausal women (251 with diabetes, 149 without diabetes). Quantitative culture on midstream urine samples was done according to the standard microbiological practices. Structured questionnaires and medical records were used to get clinical and demographic data. Multivariate logistic regression was employed to determine independent factors associated with ASB.</p> Results <p>The general prevalence of ASB was 22.0% (<i>n</i> = 88), with a significantly higher rate in diabetic women compared to the control group (27.9% vs. 12.1%; <i>p</i> &lt; 0.001). In the overall population, diabetes status (OR = 8.59; 95% CI: 1.99–37.0), HbA1c (OR = 2.52), and prior UTI history (OR = 3.98) were strong independent predictors. Within the diabetic subgroup, HbA1c (OR = 2.61; <i>p</i> &lt; 0.001), history of UTIs (OR = 3.68), and age (OR = 1.13) remained the most significant predictors. Notably, the duration of diabetes was not a significant factor in this cohort.</p> Conclusion <p>ASB is highly prevalent in diabetic postmenopausal women and strongly linked to poor glycaemic control, increased age, prior UTI, and exposure to antibiotics. These results highlight the importance of more focused prevention strategies and glycaemic control instead of general screening of ASB among this high-risk group.</p> Clinical trial number <p>Not applicable.</p>