Patient empowerment remains a critical component in the management of non-communicable diseases, particularly in low-resource settings where health system constraints limit continuity of care. Diabetes and hypertension are increasingly prevalent in Rwanda, requiring sustained patient engagement and self-management. This study assessed patient empowerment and explored digital health readiness among individuals receiving care for diabetes and/or hypertension across selected hospitals in Rwanda. A cross-sectional design was employed, involving 930 patients from six hospitals using a structured assessment tool. Patient empowerment was evaluated across domains of knowledge, self-monitoring, treatment adherence, access to care, and support systems, while digital readiness included device ownership and communication preferences. The findings revealed substantial variability in empowerment across facilities, with higher levels in knowledge and confidence compared to access to care, structured education, and support systems. Basic mobile phone ownership was high, while smartphone use and digital literacy remained limited. Patients preferred in-person and printed education as they are used to, although SMS-based communication emerged as the most feasible digital intervention. Overall, patient empowerment remains suboptimal, but SMS-based approaches offer a scalable opportunity to strengthen self-management in resource-limited settings.