Hypoglycemia is a well-known acute complication of diabetes treatment and regarded as a major obstacle to achieve glycemic targets in patients with type 2 diabetes. Especially, severe hypoglycemia (SH) has been considered as an important complication which can have a critical impact on adverse consequences in type 2 diabetes. There are several reports that hypoglycemia may be associated with cardiovascular disease (CVD) and mortality in type 2 diabetes. Although the pathogenic mechanisms implicated in CV outcome or CV mortality among patients with hypoglycemia or SH remain elusive, recent evidence suggests that hypoglycemia or SH may contribute to the increased risk of adverse CV events in type 2 diabetes. In our long-term, prospective observational cohort study, we found that SH was significantly associated with increased risks of death from both CV events and any cause in Korean patients with type 2 diabetes. According to this study, patients with experience of SH had 2.6 times higher risk of all-cause mortality during the follow-up period, as compared with those without an SH episode. The results were independent of glycemic control status, diabetic duration, age, diabetic nephropathy, use of insulin, or history of CVD. To reduce the risk of CV mortality or all-cause mortality, it is important to not only take measures to prevent SH but also carefully screen the type 2 diabetes population with a high risk of CVD and a hi