Background: A variety of circulatory abnormalities including atherosclerosis is a major complication of diabetes mellitus. In contrast to Western countries, incidence of extensive atherosclerotic complication is thought to be very low in Korean diabetic patients. Methods: Recently, we have experienced an autopsy case of 66-year-old male with type 2 diabetes mellitus having severe atherosclerosis in major arteriss. Results: Autopsy examination revealed severe ulcerative atherosclerosis in aorta and atheromatous embolization in numerous small and medium sized arteries of lung, kidney, liver, and intestine. Multiple old infarcts were noticed in myocardium and brain. In addition, severe diabetic nephropathy and pyelonephritis were also observed in kidneys. Conclusion: The cause of death in this case is assumed to be myocaridial infarc- tion associated with obstruction of coronary arteries. This case suggests that incidence of extensive atherosclerosis in Korean diabetic patients may not be rare, if autopsy examination are performed more thoroughly on these patients (J Kor Diabetes Asso 24:97-101, 2000).