The use of noninvasive imaging techniques like electron beam and multislice computed tomography, to measure coronary artery calcium, is becoming increasingly accepted for risk stratification in both symptomatic and asymptomatic populations. The National Cholesterol Education Panel guidelines indicate that measurement of coronary calcium is an option for advanced risk assessment in appropriately selected persons. Because of the recognized high risk for cardiovascular events in patients with diabetes, they belong to the same high-risk category previously reserved for patients with known coronary heart disease. Diabetic patients might benefit from risk stratification with these noninvasive techniques. Indeed, absence of coronary calcium might indicate a low risk for events, while the presence of moderate to high calcium scores may help physicians to better gauge the intensity of medical therapy provided to their patients.