The incidence and prevalence of type 2 diabetes mellitus increase daily. It is estimated that more than 400 million people have this disease and many are unaware of it. Diabetes mellitus produces unfavorable microvascular and macrovascular outcomes. Over the years it has been found that intensive glycemic control has benefits over microvascular outcomes; however, it had not been possible to demonstrate satisfactory macrovascular outcomes until recent years when, thanks to new molecules, this benefit has been demonstrated. This is why the therapeutic approach of type 2 diabetes mellitus has changed, and no longer consists in simply achieving a goal in glycated hemoglobin (HbA1c), but also in reducing cardiovascular risk with the aim of decreasing micro and especially macrovascular events. In recent years, new therapeutic targets have been identified for the treatment of this entity, with the development of molecules that have demonstrated an acceptable glycemic control as well as cardiovascular safety; some have even been shown to decrease cardiovascular risk. This article discusses the importance of cardiovascular risk in people with type 2 diabetes mellitus and therapeutic options that have an impact on this risk.