Diabetes and the cardiometabolic syndrome (CMS) are evolving as global epidemics. In the United States, diabetes affects 20 million people, with 47 million afflicted with the CMS. These disorders have a higher propensity for women, particularly in minority populations with disproportionate increase in cardiovascular disease (CVD) morbidity and mortality. Despite the decline in CVD mortality rates in the general population over the past 35 years parallel to the advances in therapeutic interventions, these rates have increased in women with diabetes. Early preventive measures for CVD risk factor through behavioral and lifestyle modification, smoking cessation, and reduction in psychosocial stressors, as well as pharmacotherapy, are among the currently supported approaches to CVD risk reduction in this high-risk population. In this article, we discuss CVD in people with diabetes and the CMS, with emphasis on minority women, a particularly vulnerable population.