Objectives: This study evaluated the relationship between diabetic retinopathy (DR) and coronary artery diseases (CAD) in type 2 diabetes mellitus (DM) patients taking the concern of risk factor assessment.Subjects and Methods: Type 2 diabetes subjects (n = 113) were selected from outpatientdiabetes clinics in the state of Kuwait during 6 months period.Data collected regards toage, gender, smoking status, duration of DM, BMI, blood pressure, HbA1c, lipid profile, medications, presence of CAD, and fundoscopy according to the International Clinical Classification of Diabetic Retinopathy. Results: The prevalence of CAD was higher among subjects with DR compared with those without DR (44.2% vs. 19.7%; P = 0.005). Logistic regression analysis revealed that independent risk factors for CAD were age and triglyceride (TG) level, while those for retinopathy included insulin and Total Cholesterol (TC) level.Conclusions: This retrospective study demonstrated a link between macroangiopathy and microangiopathy in subjects with type 2 DM, i.e., the occurrence of CAD increased with the progression and severity of retinopathy. We recommend repeated fundus examination at least yearly not only for preserving their vision, but also for early detection of cardiac ischemic events.