Background: Cardiovascular complications are the major cause of diabetes- associated morbidity and mortality. Coronary artery calcium score (CACS) was found to be a powerful predictor of coronary artery disease (CAD). The presence of extra-coronary calcification as a useful predictor of CAD is not yet established. In this study, we tested the hypothesis that young diabetic patients may have increased coronary and extra-coronary calcification as a reflection of increased atherosclerotic burden.Methods: We studied 380 patients (151 were diabetics) under age of 60 years who were scheduled for computed tomography coronary angiography (CTCA) because of suspected CAD. Severity of CAD was assessed by Gensini score. CACS as well as calcium score in the aortic valve (AVC), mitral annulus (MAC), ascending aorta (AAC) and descending aorta (DAC) were measured by 256-multidetector computed tomography (MDCT) scanner with dedicated software for calcium calculation. Patients with known CAD were excluded.Results: Diabetic and no-diabetic patients had comparable age. However, diabetics had higher Gensini score, CACS and extra-coronary calcium score (ECCS), as shown in table. Multiple logistic regression analyses were performed to examine the association between various CAD risk factors and calcium scores. Diabetes was found to be the strongest predictor of CACS and ECCS (Odds ratio [OR]= 2.38, confidence interval [CI]= 1.4-3.9, p=0.001) and (OR= 3.7, CI= 2.3-6.2, p= 0.000) respectively.Conclusion: Young diabetic patients had increased coronary and extracoronary atherosclerotic burden.