Over 20 million people are affected by diabetes in India. These numbers are expected to increase to 57 million by 2025. Diabetic patients are at increased risk of atherosclerosis and its clinical sequelae, particularly coronary artery disease (CAD). CAD remains the most important cause of mortality among diabetic patients. The pathophysiological process of atherosclerosis in diabetic subjects is accelerated by several factors such as hyperglycaemia, insulin resistance, abnormal lipid profile, oxidative modification of lipoproteins, increased blood pressure, altered rate of fibrinolysis, etc. These changes in diabetics render the dormant atherosclerotic plaque vulnerable precipitating an early clinical event. Thus CAD in diabetic subjects carries a worse prognosis than in non-diabetic subjects. This review focuses on the potential role of various risk factors contributing to atherosclerosis in diabetic patients.