Background:The effect of diabetes on health resides majorly in its characteristic complications. It is linked to a higher frequency of macrovascular complications (MVC), such as atherosclerotic vascular disorders, which are the foremost cause of death for people with diabetes. Several studies have shown inconsistent methods by which diabetes accelerates atherosclerosis. Aim: The study explored the circulating N ε - carboxymethyllysine (CML) role as one of the advanced glycation endproducts (AGEs) in MVC development in type 2 diabetic (T2D) patients. Also, the possible relationship between it and the other predictors of MVC. Methods: The study included 3 groups: Group I (Control): 15 healthy individuals. Group II: 20 T2D patients without MVC. Group III: 20 T2D patients with stable MVC. Results: This study indicated that Oxidized LDL appears to be atherogenic and its plasma level can be used as a marker/predictor for macrovascular MVC, also the ratio of OxLDL and HDL serves as a valuable new atherogenic marker instead of conventional atherogenic markers. The circulating level of CML is increased in diabetic patients with MVC compared with diabetics without MVC. CML correlates significantly with carotid Intima-media thickness, denoting the role of AGEs in the development of MVC in these diabetic patients. Conclusion: CML plasma level may be used as a diagnostic and prognostic marker for MVC development in diabetic patients