diff --git a/src/api/api.ts b/src/api/api.ts
index c55245f4..c853c153 100644
--- a/src/api/api.ts
+++ b/src/api/api.ts
@@ -1,6 +1,6 @@
 import { fhirBaseUrl, openmrsFetch, restBaseUrl } from '@openmrs/esm-framework';
 import { encounterRepresentation } from '../constants';
-import { type OpenmrsForm, type PatientIdentifier, type PatientProgramPayload } from '../types';
+import { type DiagnosisPayload, type OpenmrsForm, type PatientIdentifier, type PatientProgramPayload } from '../types';
 import { isUuid } from '../utils/boolean-utils';
 
 export function saveEncounter(abortController: AbortController, payload, encounterUuid?: string) {
@@ -173,3 +173,15 @@ export function savePatientIdentifier(patientIdentifier: PatientIdentifier, pati
     body: JSON.stringify(patientIdentifier),
   });
 }
+
+export function savePatientDiagnosis(abortController: AbortController, payload: DiagnosisPayload) {
+  return openmrsFetch(`${restBaseUrl}/patientdiagnoses`, {
+    headers: {
+      'Content-Type': 'application/json',
+    },
+    method: 'POST',
+    body: payload,
+    signal: abortController.signal,
+  });
+}
+
diff --git a/src/components/encounter/encounter-form-manager.ts b/src/components/encounter/encounter-form-manager.ts
index fa929527..c1fe2ddf 100644
--- a/src/components/encounter/encounter-form-manager.ts
+++ b/src/components/encounter/encounter-form-manager.ts
@@ -8,7 +8,13 @@ import {
   type PatientProgramPayload,
 } from '../../types';
 import { type EncounterContext } from '../../form-context';
-import { saveAttachment, saveEncounter, savePatientIdentifier, saveProgramEnrollment } from '../../api/api';
+import {
+  saveAttachment,
+  saveEncounter,
+  savePatientDiagnosis,
+  savePatientIdentifier,
+  saveProgramEnrollment,
+} from '../../api/api';
 import { hasRendering, hasSubmission } from '../../utils/common-utils';
 import { voidObs, constructObs } from '../../submission-handlers/obsHandler';
 import dayjs from 'dayjs';
@@ -152,6 +158,19 @@ export class EncounterFormManager {
     const ac = new AbortController();
     return Promise.all(patientPrograms.map((programPayload) => saveProgramEnrollment(programPayload, ac)));
   };
+
+  static saveDiagnosis = (fields: FormField[], encounter: OpenmrsEncounter) => {
+    const diagnoses = fields?.filter((field) => field.type === 'diagnosis' && hasSubmission(field));
+    if (!diagnoses) return [];
+    const ac = new AbortController();
+    return diagnoses.map((diagnosis) => {
+      const payload = {
+        ...diagnosis.meta.submission.newValue,
+        encounter: encounter.uuid,
+      };
+      return savePatientDiagnosis(ac, payload);
+    });
+  };
 }
 
 // Helpers
diff --git a/src/components/encounter/encounter-form.component.tsx b/src/components/encounter/encounter-form.component.tsx
index 4f39fc77..e0246474 100644
--- a/src/components/encounter/encounter-form.component.tsx
+++ b/src/components/encounter/encounter-form.component.tsx
@@ -531,6 +531,25 @@ const EncounterForm: React.FC<EncounterFormProps> = ({
           isLowContrast: true,
         });
       }
+      // handle encounter diagnosis
+      try {
+        const saveDiagnoses = await EncounterFormManager.saveDiagnosis(fields, savedEncounter);
+        if (saveDiagnoses) {
+          showSnackbar({
+            title: t('encounterDiagnosisSaved', 'Encounter diagnosis saved successfully'),
+            kind: 'success',
+            isLowContrast: true,
+          });
+        }
+      } catch (error) {
+        const errorMessages = extractErrorMessagesFromResponse(error);
+        return Promise.reject({
+          title: t('errorSavingEncounterDiagnosis', 'Error saving encounter diagnosis'),
+          subtitle: errorMessages.join(', '),
+          kind: 'error',
+          isLowContrast: false,
+        });
+      }
       // handle attachments
       try {
         const attachmentsResponse = await Promise.all(
diff --git a/src/constants.ts b/src/constants.ts
index 1583fa72..5965ee8c 100644
--- a/src/constants.ts
+++ b/src/constants.ts
@@ -5,6 +5,7 @@ export const encounterRepresentation =
   'custom:(uuid,encounterDatetime,encounterType:(uuid,name,description),location:(uuid,name),' +
   'patient:(uuid,display),encounterProviders:(uuid,provider:(uuid,name),encounterRole:(uuid,name)),' +
   'orders:(uuid,display,concept:(uuid,display),voided),' +
+  'diagnoses:(uuid,certainty,condition,display,rank,voided,diagnosis:(coded:(uuid,display))),' +
   'obs:(uuid,obsDatetime,comment,voided,groupMembers,formFieldNamespace,formFieldPath,concept:(uuid,name:(uuid,name)),value:(uuid,name:(uuid,name),' +
   'names:(uuid,conceptNameType,name))))';
 export const FormsStore = 'forms-engine-store';
diff --git a/src/registry/inbuilt-components/inbuiltFieldSubmissionHandlers.ts b/src/registry/inbuilt-components/inbuiltFieldSubmissionHandlers.ts
index 00229ccd..6e6db543 100644
--- a/src/registry/inbuilt-components/inbuiltFieldSubmissionHandlers.ts
+++ b/src/registry/inbuilt-components/inbuiltFieldSubmissionHandlers.ts
@@ -11,6 +11,7 @@ import { EncounterRoleHandler } from '../../submission-handlers/encounterRoleHan
 import { ProgramStateHandler } from '../../submission-handlers/programStateHandler';
 import { InlineDateHandler } from '../../submission-handlers/inlineDateHandler';
 import { ObsCommentHandler } from '../../submission-handlers/obsCommentHandler';
+import { EncounterDiagnosisHandler } from '../../submission-handlers/encounterDiagnosisHandler';
 
 /**
  * @internal
@@ -76,4 +77,9 @@ export const inbuiltFieldSubmissionHandlers: Array<RegistryItem<SubmissionHandle
     component: ObsCommentHandler,
     type: 'obsComment',
   },
+  {
+    name: 'EncounterDiagnosisHandler',
+    component: EncounterDiagnosisHandler,
+    type: 'diagnosis'
+  }
 ];
diff --git a/src/submission-handlers/encounterDiagnosisHandler.ts b/src/submission-handlers/encounterDiagnosisHandler.ts
new file mode 100644
index 00000000..30c26902
--- /dev/null
+++ b/src/submission-handlers/encounterDiagnosisHandler.ts
@@ -0,0 +1,50 @@
+import { gracefullySetSubmission } from '../utils/common-utils';
+import { type EncounterContext, type FormField, type OpenmrsEncounter, type SubmissionHandler } from '..';
+
+export const EncounterDiagnosisHandler: SubmissionHandler = {
+  handleFieldSubmission: (field: FormField, value: any, context: EncounterContext) => {
+    const newValue = constructNewDiagnosis(value, field, context.patient.id);
+    gracefullySetSubmission(field, newValue, null);
+    return newValue;
+  },
+  getInitialValue: (
+    encounter: OpenmrsEncounter,
+    field: FormField,
+    allFormFields: Array<FormField>,
+    context: EncounterContext,
+  ) => {
+    if (encounter?.diagnoses?.length > 0) {
+      if(field.questionOptions.rank === 1) {
+        return encounter.diagnoses.find((entry) => entry.voided === false && field.questionOptions.rank === entry.rank)?.diagnosis
+        ?.coded?.uuid;
+      } else {
+        return encounter.diagnoses.find((entry) => entry.voided === false && field.questionOptions.rank !== entry.rank)?.diagnosis
+        ?.coded?.uuid;
+      }
+    } else {
+      return;
+    }
+  },
+
+  getDisplayValue: (field: FormField, value: any) => {
+    return value;
+  },
+  getPreviousValue: (field: FormField, encounter: OpenmrsEncounter, allFormFields: Array<FormField>) => {
+    return null;
+  }
+};
+
+const constructNewDiagnosis = (value: any, field: FormField, patientUuid: string) => {
+  if (!value) {
+    return null;
+  }
+  return {
+    patient: patientUuid,
+    condition: null,
+    diagnosis: {
+      coded: value,
+    },
+    certainty: 'CONFIRMED',
+    rank: field.questionOptions.rank, // rank 1 denotes a diagnosis is primary, else secondary
+  };
+};
\ No newline at end of file
diff --git a/src/types.ts b/src/types.ts
index 8670b756..87086643 100644
--- a/src/types.ts
+++ b/src/types.ts
@@ -252,6 +252,7 @@ export interface FormQuestionOptions {
   showComment?: boolean;
   comment?: string;
   shownCommentOptions?: { validators?: Array<Record<string, any>>; hide?: { hideWhenExpression: string } };
+  rank?: number;
 }
 
 export type SessionMode = 'edit' | 'enter' | 'view' | 'embedded-view';
@@ -305,6 +306,7 @@ export interface OpenmrsEncounter {
   visit?: OpenmrsResource | string;
   encounterProviders?: Array<Record<string, any>>;
   form?: OpenmrsFormResource;
+  diagnoses?: Array<Diagnosis>;
 }
 
 export interface OpenmrsObs extends OpenmrsResource {
@@ -471,3 +473,27 @@ export interface PatientProgramPayload {
     endDate?: string;
   }>;
 }
+
+export interface DiagnosisPayload {
+  encounter: string;
+  patient: string;
+  condition: null;
+  diagnosis: {
+    coded: string;
+  };
+  certainty: string;
+  rank: number;
+}
+
+export interface Diagnosis {
+  patient: string;
+  diagnosis: {
+    coded: {
+      uuid: string;
+    };
+  };
+  certainty: string;
+  rank: number;
+  display: string;
+  voided: boolean;
+}