Diabetes melitus is a critical risk factor for coronry artery disease, this is making patients have diffuse, severe and rapidly progressive CAD and is significant accompanied with high rates of ischemic complications and recurrent revasculariztion in these patients. The best method of revasculariztion for diabetic patients with multivesel CAD is a topic of uncertainty. to evaluate clinical outcome in diabetic patients with three vessel disease who had either PCI (group A) compared to CABG (group B). This study included 120 diabetic patients who were admitted to cardiology department in Benha University hospitals & National heart institute, Egypt during the period from November 2018 to Novrmber 2019 who had three vessel disease or left main coronary artery disease during diagnostic coronary angiography and were divided in to two groups: Group A: underwent PCI with DES and Group B: underwent CABG. Five percent of patients complicated by death after 12 months (2% versus 8% in group A, B respectively, P=0.452), 4% complicated by non-fatal MI after 12 months (0.00% versus 6% in group A, B respectively, P=0.442), 6% was complicated by non-fatal stroke after 12 months (0.00% versus 16% in group A, B respectively, P=0.008). higher incidence of Non-fatal stroke was found in patients who were assigned to CABG compared to PCI. However, the need for revascularization was significantly higher in PCI compared to CABG after 6 months of follow up.