Background: Diabetes mellitus is highly prevalent amongst patients with heart failure, especially those with heart failure and preserved ejection fraction (HFpEF), and patients with the two conditions have a higher risk of mortality compared with patients without diabetes or heart failure. The aim of the study is todetermine the prevalence of heart failure among type 2 diabetic patients in Benha city, Egypt and to assess the different causes and risk factors of heart failure (HF) and the impact of glycemic control on the prevalence of HF as well as the effect of different anti-diabetic drugs on control of HF. Patients and methods: This cross-sectional study was conducted on 200 patients with type 2 diabetes attending the outpatient and inpatient clinics of Benha teaching hospital. All included patients were subjected to full history taking, complete clinical examination and laboratory investigations. Results: The prevalence of HF in diabetic patients was 35.5% [28 (39.4%) females and 43 (60.6%) males], while patients without heart failure represented 64.5% [85 (65.9%) females and 44 (34.1%) males]. The mean age was 60 (SD 11) for patients with HF, and 58 (SD 11) years for those without HF. Glycemic control was significantly lower in those with HF (9.9%) than those without HF (68.2%), with p < 0.001.Fasting blood glucose and HBA1c were significantly higher in those with HF failure than those without HF (p < 0.001). The number of patients with HF who were on sulfonylurea and thiazolidinediones (TZD) was significantly higher than those without HF who were using them. Conclusion: There is a strong association between type 2 diabetes and both prevalent and incident HF. TZDs are not recommended in patients with symptomatic heart failure, and initiation of therapy is contraindicated in patients with established HF.