The prevalence of diabetes mellitus (DM) that is about 150 million today is estimated to exceed 300 million by the year 2025 (1). When considered that about half of the patients remain undiagnosed, it can be seen how serious the dimensions of the disease are (2). In the patients with DM more than 90% of whom are consisted by non-insulin dependent diabetes mellitus (NIDDM, Type 2 DM), the disease is a significant risk factor for the development of coronary artery disease (CAD) responsible for 75% of all deaths (3,4). In this group of the patients who generally require antidiabetic treatment inevitably, it is highly important to decide on an appropriate treatment due to the various cardiovascular (CV) effects of the anti-diabetics medications and drugs. In order to help establish this decision, in this review it was tried to investigate antidiabetic drugs after a general approach to CAD pathophysology in diabetic patients, especially in terms of their cardiovascular effects.