This study examined the association between self-reported diabetes, fish consumption and serum levels of organochlorines in a First Nation community. One quarter of the 101 participants reported diabetes. Serum PCBs, but not p,p'-DDE, were positively correlated to consumption frequency of total fish, walleye and pike, but not trout. Reported diabetes was positively associated to p,p'-DDE and some PCB congeners. Odds Ratios (OR) for reported diabetes for those in the upper 75th percentile for serum p,p'-DDE compared to the others were 3.5 (95% CI 1-13.8) and 6.1 (95% CI 1.4-27.3) (weight wet and lipid-standardized values, respectively) and for total sum of PCBs: 4.91 (95% CI 1.4-19.0) and 5.51 (95% CI 1.3-24.1). For participants who were in the upper 50th percentile for trout and white fish intake, reported diabetes was respectively 6 and 4 times lower compared to the others. These findings support the hypothesis that environmental exposure to elevated p,p'-DDE and PCBs is associated with increased risk of diabetes. Consumption of trout and white fish may be beneficial to reduce risk.