Introduction: Atherothrombotic cardiovascular disease is the major cause of disability and death in diabetic patients. Dyslipidemia and inflammation play a major role in the pathogenesis of atherothrombotic cardiovascular disease in diabetic patients. We aimed to assess the association between platelet volume and the atherogenic index of plasma in relation to atherothrombotic cardiovascular disease in diabetes. Material and Methods: In 108 diabetic patients, which were divided into two groups according to the atherothrombotic cardiovascular disease, we assessed the mean platelet volume and the atherogenic index of plasma. In diabetic patients without atherothrombotic cardiovascular disease, we calculated the Framingham risk score, which was then correlated with the mean platelet volume and atherogenic index of plasma. Results: The mean platelet volume and atherogenic index of plasma were significantly higher in diabetic patients with atherothrombotic cardiovascular disease. Also, both were increased in diabetic patients with a high calculated Framingham risk score compared to other groups. There was a statistically significant positive correlation between atherogenic index of plasma, mean platelet volume, and Framingham risk score (n= 54, r = 0.595, P < 0.0001 and r = 0.473, P = 0.0003). Conclusions: This study concluded that the mean platelet volume and the atherogenic index of plasma are increased in diabetic patients with atherothrombotic cardiovascular disease. Also, they were increased in diabetic patients with higher Framingham risk score and this may confer future risk for atherothrombotic cardiovascular events.