Background: Diabetes is a common and serious disease leading to chronic, mostly irreversible macro and microvascular complications.Methods: 50 Patients, attending Diabetic OPD at SGRD hospital, Amritsar. Asymptomatic patients with no symptoms or history of IHD and normal ECG with microalbuminuria were enrolled in the study. A complete clinical examination was done.Results: The prevalence of microalbuminuria increased with worsening glycemic control, as evidenced by prevalence of 74 % in patients with HbA1c of more than 9 percent. The prevalence of microalbuminuria increased with the duration of diabetes, as evidenced by prevalence in 48 % in patients, with duration of diabetes of more than 11 years. The prevalence of microalbuminuria increased with increased in BMI, as evidenced by prevalence of 56 % in overweight Patients. The prevalence of microalbuminuria increased in patients of Diabetic Retinopathy, as evidenced by prevalence of 82 % in patients of Diabetic Retinopathy. In the present study, 70.8 % patients with duration of diabetes in the range 11-15 years had positive treadmill test.Conclusions: Hence, in this study it was observed that longer the duration of diabetes with microalbuminuria, greater is the predisposition for silent myocardial ischemia. In the present study, 64 % of asymptomatic patients with microalbuminuria had a positive treadmill exercise test. Hence, we deduce from this study that microalbuminuria is an independent risk factor for silent myocardial ischemia.