Object: RANTES and its receptor system play a pivotal role of development of obesity and atherosclerotic changes in vessel. The aim of this study was to compare the prevalence of diabetic complications and RANTES 59029A/G polymorphism according to body mass index in type 2 diabetes over 15 years. Methods: Total of 271 Korean type 2 diabetic subjects over 15 years from the Endocrinology clinic of Chungbuk National University Hospital were enrolled in this study. Biochemical results and anthropometric parameters were assessed according to the available medical records. The obesity was defined according to “Asian obesity standard” by World Health Organization in the western Pacific region. The RANTES 59029A/G polymorphism genotyping was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Results: The type 2 diabetes whose BMI over 25 kg/㎡ have higher frequency of RANTES (AA+AG genotype) than the type 2 diabetes whose BMI below 25 kg/㎡ (72.0% vs. 64.3%). The prevalence of metabolic risk factors, such as hypertension and dyslipidemia was higher in the type 2 diabetes whose BMI over 25 kg/㎡ than the type 2 diabetes whose BMI below 25 kg/㎡. Cardiovascular complications was significantly higher in the subjects with BMI over 25 kg/㎡ compared to those with BMI below 25 kg/㎡ (83.5% vs. 72.0%, p < 0.05). The prevalence of any other microvascular complications were not different according to the BMI. Conclusion: The higher BMI in type 2 diabetes over 15 years have the higher prevalence of metabolic risk factors and cardiovascular complications. Also, our findings suggest that RANTES 59029A/G polymorphism may contribute to the obesity in Korean type 2 diabetes over 15 years.