The aim of this study in 2006-08 was to determine the prevalence and risk factors of CVD in an Iranian population of patients with type 2 diabetes mellitus. History and physical examinations were recorded and laboratory tests were performed in 752 patients attending the Mashhad Endocrine and Metabolism Research Center. The prevalence of CVD was 20.1%. CVD was significantly associated with age, duration of diabetes, hypertension, diabetic retinopathy, metabolic syndrome, renal insufficiency, triglycerides, high-density lipoprotein (HDL) cholesterol, uric acid and triglycerides/HDL ratio. Using a logistic regression model, age, metabolic syndrome and HDL cholesterol were significant independent predictors of CVD. The high prevalence of CVD in Iranian patients with type 2 diabetes underscores the importance of better detection and treatment of metabolic risk factors of CVD in these patients.