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Aim This paper is a report of concept analysis of self-efficacy in elderly with diabetes in China. Methods Literature was systematically retrieved from 2000 to 2011 using five databases: Cumulative Index to Nursing and Allied Health Literature, MEDLINE, OVID, PsycInfo, and Web of Science. The key words used in the search were self-efficacy, diabetes, type 2, aged, self-care, and China. The electronic search was supplemented by a manual search of current issues of periodicals and follow-up of other cited materials, where appropriate. A total of 45 articles were retrieved. After a careful review of the 45 articles most relevant to the topic, 31 articles remained. They were used to complete a concept analysis using Walker and Avant's technique. Results Four defining attributes of self-efficacy were identified: (a) cognitive recognition of requisite specific techniques and skills required to undertake diabetes self-management, (b) perceived expectations of the outcomes of self-management, (c) confidence in the capability to perform self-management, and (d) sustained efforts in self-management of diabetes. Conclusions Self-efficacy has been an important determinant in self-management among elderly with diabetes. The application of self-efficacy should be incorporated into decision-making and problem-solving procedures when caring for older adults with diabetes. [ABSTRACT FROM AUTHOR]