The prevalence of silent myocardial ischemia (SMI) was studied in 96 subjects, aged 40 to 75 years, with diabetes millitus and without cardiac symptoms. Its relation to the duration of diabetes, the presence of diabetes-induced nephropathy, retinopathy and peripheral neuropathy, as well as risk factors for coronary artery disease, were also evaluated. Exercise-induced SMI, defined as 1≥ mm of ST-segment depression and thallium perfusion defect, was detected in 13 patients (14%). The duration of diabetes in the patients with SMI was not so long, averaging 2.8±3.0 years. The extent of nephropathy, retiopathy and peripheral neuropathy, and the presence of hyperlipidemia were similar in patients with and without SMI. The presense of hypertension and cigarette smoking were significantly correlated in patiens with SMI. It is concluded that SMI occurs frequently in asymptomatic patients wiht short duration of diabetes.