This paper reviews the risk factors that may contribute to atherosclerotic vascular disease in diabetics. Many of the risk factors have been identified on the basis of cross-sectional clinical studies or from mortality data, and as a result various aetiological hypotheses about the mechanism of atherogenesis have been formed. Because of the importance of identifying changes in the arterial wall well in advance of the clinical events that lead to morbidity or mortality, emphasis is given also to the various techniques of non-invasive assessment of vascular disease that can be applied to diabetic as well as non-diabetic patients. One particular form of non-invasive investigation of arterial function, namely the Doppler pulse rate velocity and wave-form analysis, is comparatively simple. We present some preliminary data to suggest that this technique may be useful in the evaluation of pre-symptomatic stages of atherosclerosis in diabetes.