Background: ICAM-1 has a vital responsibility in the adhesion of circulating leucocytes to the blood vessel wall and subsequent transendothelial migration to the vascular intima, one of the earliest stepladders in atherogenesis. Objective: To investigate the possible role of the K469E polymorphism of the ICAM-1 in genetic susceptibility to MI amongst the patients with type 2 diabetes. Subjects &Methods: The study included 70 patients divided into two groups: Group I included 35 patients suffering from type 2 DM with MI, Group II included 35 patients with type 2 DM without CAD, 30 apparently healthy age and gender matched subjects were involved as a control group. For all subjects the followings were done: History taking & clinical examination, ECG, lipid profile, HbA1c, sICAM-1 by ELISA. Polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) method was used to determine the distribution of allele and genotype frequencies of the 469 E/K polymorphism of the ICAM-1. Results: There were high statistical significant between ICAM level of Group 1 (468±40.4 ng/ml) and both Group II (266.4±44.1 ng/ml) & the controls (150.6±29.7ng/ml p