The contribution of the hemostatic system in the development of cardiovascular disease (CVD) in patients with type 2 diabetes is not completely defined. The aim of this study was to elucidate associations of hemostatic factors with the development of CVD in patients with type 2 diabetes. Patients with type 2 diabetes without CVD (n = 113), with CVD (n = 94), and controls without CVD (n = 100) were enrolled in this study. Several hemostatic markers were measured. A disturbed hemostatic balance in patients with type 2 diabetes was observed as illustrated by hypofibrinolysis and increased levels of von Willebrand factor (vWF) and plasminogen-activator inhibitor 1 (PAI-1). Patients with type 2 diabetes with CVD have more thrombin generation compared to patients without CVD. This hemostatic imbalance might contribute to the development of CVD in patients with type 2 diabetes.