Systemic diseases have higher risk of compromised oral health like tooth loss, higher lifetime caries experience thus emphasising the significant relationship between systemic disease and oral conditions. Dental caries is considered a serious public health problem affecting the long term prognosis of teeth and contributes to a major global burden of oral diseases among adults. Hence, this study aims to assess the caries risk profile among adults with systemic disease. A retrospective study was conducted among 61 participants aged 35 years and above. Data was collected using the electronic patient records, between the time period of August 2019 - January 2020, yielding a total of 61 participants with complete data. Plaque accumulation score using Loe and Silness Index, dental caries experience, salivary flow rate, fluoride exposure were recorded and entered into Cariogram application, to generate a pie chart in order to categorise patients into different caries risk groups. Descriptive statistics and Chi square were performed to analyze the data. The mean age of the participants was 55.2±10.9 years. Among all participants, 40.9% had diabetes. When categories into different caries risk groups, 37.1% were categorised into “high medium risk” group. Statistical significant value of p <0.05 was found between cariogram score and systemic disease. Systemic diseases have a significant effect on the deterioration of oral health, especially in terms of carious lesions. Caries risk assessment should be carried out compulsorily for patients with systemic diseases to reduce the burden of dental caries, as an early assessment will lead to better prognosis and better quality of life.