Objective To explore the relationship between dyslipidemia and cardiovascular disease risk in 340 patients with diabetes mellitus (DM). Methods A retrospective analysis was conducted on the clinical data of 340 DM patients who visited the West China Hospital of Sichuan University from January 2020 to January 2024 and were followed up for at least one year. According to the occurrence of cardiovascular disease in DM patients within 1 year of follow-up after treatment, the patients were divided into occurrence group and non-occurrence group. The demographic and related disease indicators in the two groups were statistically analyzed, and univariate analysis was performed. Binary logistic regression analysis was used to analyze the independent risk factors affecting the risk of cardiovascular disease in DM patients. Results The survey results showed that 38 out of 340 DM patients developed cardiovascular disease within 1 year of follow-up after treatment, accounting for 11.18%, and 302 cases did not develop cardiovascular disease, accounting for 88.82%. There were no statistical differences in gender, age, education level, family history of DM, smoking history and alcohol drinking history between the two groups (P>0.05). The proportions of DM course (>10 years), hypertension history and abnormal blood lipid-related indicators in the occurrence group were higher than those in the non-occurrence group (P<0.05). Binary logistics regression analysis showed that DM course>10 years, history of hypertension and abnormal blood lipid-related indicators were independent risk factors affecting the risk of cardiovascular disease in DM patients (P<0.05). Conclusion The course of DM, history of hypertension, and abnormal blood lipid-related indicators in DM patients significantly increase the risk of cardiovascular disease. It is necessary to actively monitor and manage blood lipid levels to reduce the risk of cardiovascular disease.