Type 2 diabetes mellitus (T2DM) is strongly associated with atherosclerotic cardiovascular disease (CVD), and diabetic dyslipidemia is a major modifiable risk factor. Regional Indian data, especially from North Karnataka, remain limited.Methods: This hospital-based cross-sectional case–control study included 100 T2DM patients and 100 age- and sex-matched healthy controls attending a tertiary-care teaching hospital in Vijayapur, Karnataka. All subjects underwent clinical evaluation, waist–hip ratio (WHR) measurement, fasting blood sugar estimation and fasting lipid profile (TC, TG, LDL-C, HDL-C, VLDL-C); CVD risk was assessed clinically and using ECG and 2D echocardiography.Results: Most patients were between 51–60 years of age and sex distribution was similar in both groups. Dyslipidemia was present in 77% of T2DM cases versus 8% of controls, with significantly higher mean fasting TC, TG and LDL-C and significantly lower HDL-C in diabetics (p < 0.05 for all). Elevated CVD risk was observed in 76% of T2DM patients compared with 24% of controls (p < 0.05).Conclusions: Fasting dyslipidemia is highly prevalent among T2DM patients in this North Karnataka cohort and shows a strong association with increased CVD risk. Routine fasting lipid profiling and early aggressive lipid management should be integral to diabetes care in similar populations.