Background: One of the main five pillars of Islam is Ramadan fasting and it may carry some hazards on some patients especially elderly patients. Sodium Glucose Co-Transporter-2 inhibitors (SGLT2i) is a new family which introduced in the market few years ago and used to treat patients with Type 2 Diabetes (T2D). Objective: The objective of this study is to investigate the safety and tolerability of SGLT2i among elderly patients with T2D fasting Ramadan. Patients and methods: The current study was conducted on 100 patients aged 60 years and more, both males and females (Group 1: 50 patients on vildagliptin and metformin and Group 2: 50 patients on empagliflozin and metformin). Glycated haemoglobin (HbA1c) and estimated glomerular filtration rate (eGFR) were measured before and 2 months after Ramadan. Episodes suggesting hypoglycemia and/or volume depletion were estimated. Days to break fasting were also compared. Results: The mean age among group 1 was 65.34 + 2.9 years versus 66 + 3.4 years among group 2 [P value: 0.25]. Mean HbA1c before Ramadan was 7.26±0.46 among group 1 versus 7.28±0.53 among group 2 [P value: 0.84]. No statistically significant difference was found regarding episodes suggesting hypoglycemia and/or volume depletion nor days to break fasting. Conclusion: The conducted study has addressed that SGLT2i may be used safely and well tolerated mong elderly patients with T2D fasting Ramadan if patients were well prepared and educated before Ramadan.