Objective To explore the clinical characteristics and coronary angiographic findings in elderly coronary heart disease (CHD) patients with type 2 diabetes mellitus (T2DM) Methods A total of 471 patients (age≥60 years) with angiographically diagnosed CHD were divided into 2 groups: 179 CHD patients with T2DM and 292 CHD patients without T2DM. The data of the clinical features and selective coronary angiographics were compared between the two groups. Results Multivariate unconditional logistic regression analysis showed that low density lipoprotein cholesterol (LDL-C), fasting blood glucose(FBG) and 2h post blood glucose (2hPBG) were independently correlated with CHD patients with T2DM (P≤0.001). Compared to CHD patients without T2DM, CHD patients with T2DM suffered much more from triple vessels lesions (P＜0.010), severe coronary artery stenosis, complete occlusions and diffuse lesions (all P＜0.01), and their Gensini scores were higher (P＝0.009). Conclusions The risk factors of LDL-C, FBG and 2hPBG are independently correlated with CHD patients with T2DM. Diffuse and severe lesions are more common in elderly CHD patients with T2DM.