Background: Cardiovascular disease is the number one cause of morbidity and mortality in diabetic patients. Sonography has made it easier to study subclinical atherosclerosis by determining the Carotid Intima-Media Thickness. Aim: To investigate the significance of Carotid Intima Media Thickness (CIMT) in prediction of cardio vascular risk in Type 2 Diabetes Mellitus (T2DM) patients. Method: A total of 110 T2DM patients aged 34-96 years (mean age 54.57±10.66 years; 50% males) were enrolled in the study. Demographic details, diabetic history, level of glycemic control, anthropometric assessment, lipid profile and blood pressure were assessed. Metabolic syndrome was assessed using the IDF criteria. CIMT was assessed sonographically. CIMT >0.9 mm in either of two sides was considered as abnormal. Data was analyzed using Chi-square and Student ‘t’-test. Results: Mean CIMT was 0.81±0.22 mm. There were 46 (41.8%) patients with abnormal CIMT. Prevalence of Metabolic syndrome was 73.6%. A significant association of abnormal CIMT was seen with older age, male sex, longer duration of diabetes, diabetic treatment incorporating both insulin and oral hypoglycemic agents, blood sugar levels (both fasting and post-prandial), higher HbA1c and poor glycemic control. Among traditional cardiovascular risk factors, abnormal CIMT showed a significant association with obesity (WC and WHR), smoking habit, higher blood pressure/hypertension, higher lipid levels (TC, TG, LDL) and metabolic syndrome. Conclusion: There was a high prevalence of CIMT abnormalities in the T2DM patients which was related with demographic, disease related factors and other traditional cardiovascular risk factors. Further studies with inclusion of a control group are also recommended.