Background: Type 2 diabetes is predisposed by increased visceral obesity, insulin resistance, and B-cell dysfunction. Obesity, diabetes mellitus, and the metabolic syndrome are all risk factors for increased epicardial adipose tissue (EAT) thickness. Few published studies have examined the significance of EAT thickness in prediabetic patients and how it relates to insulin resistance, HbA1c levels, and the length of diabetes. Aim: The goal was to look at the relationship between EAT and the likelihood of developing Type 2 DM. Subjects and methods: This study included 69 subjects. Subjects were split into the following three groups: Group I consists of 23 individuals who have good blood sugar levels, Group II consists of 23 patients with prediabetes, and Group III consists of 23 patients with type 2 diabetes. All patients underwent transthoracic echocardiography to estimate epicardial adipose tissue thickness. Results: Our study reveals a statistically significant difference between the tested groups in terms of their thicker epicardial adipose tissue in diabetes than prediabetes group(p<0.05). The median epicardial fat thickness (EFT) was considerably greater in the group of people with prediabetes than healthy control group (p<0.05). There is significant and direct relation between EAT thickness of studied groups as well as HOMA-IR, BMI, and waist size (p<0.05). Conclusion: The EAT is simple, inexpensive, readily available, non-invasive, and a predictor of development of prediabetes and Type 2DM.