The prevalence of coronary artery disease (CAD) in diabetics is extremely high. AIM: We studied the role of myocardial perfusion scintigraphy (MPS) and the incidence of CAD in asymptomatic diabetics comparing them to symptomatic ones, thus aiming to their best stratification into high and low risk category of CAD. Material and method: 78 diabetics type 2, mean age 62 years, which proceeded Cardiothoracic Department of NIMTS. Inclusion criteria were appropriate control of diabetes, of hypertention, no damage in organ-targets and absence of coronary intervention. We reported the risk factors for CAD, hereditary history, possible acute coronary syndrome referrals, or angina symptoms and medication and all diabetics were subjected in myocardial perfusion study. Results: Our study revealed the high prevalence (73%) of CAD in asymptomatic diabetics included and statistically higher prevalence of CAD in male than in women ( p<0,01). Statistical correlation was reported between severity of ischemia findings and typical angina symptoms (p <0,05), duration of diabetes mellitus (DM) (p=0,003), while type of therapy (p=0,37) and number of risk factors of CAD (p =0,23) were independent. Conclusions: MPS aids the detection of silent ischemia and diabetic autonomic neuropathy in DM patients, especially the asymptomatic ones, though DM is currently thought as a CAD equivalent independently of the presence of hypertension. Thus, MPS can help to early application of appropriate medication according to the recommendations of American Society of Diabetes.