Coronary artery disease (CAD) is the most common cause of death in patients with diabetes. Many diabetics have asymptomatic CAD, and may benefit from early diagnosis. We review the recent literature to evaluate whether the current evidence supports screening for CAD in asymptomatic diabetics. Currently, no single screening modality has shown sufficient accuracy to determine which patients will have significant CAD. The combination of imaging modalities may show promise in improving the accuracy of screening, and limited data suggest that screening in this population may be associated with improved outcomes. However, based on the current evidence we presently do not recommend screening for CAD in this population.