The purpose of the research is to assess the fractalkine and asymmetric dimethylarginine (АDМА) levels in patients with coronary artery disease (CAD) depending on the presence of type 2 diabetes mellitus (T2DM) and the character of coronary arteries lesions. Materials and Methods: 131 patients with CAD (89 men, 42 women), mean age of 59.6 ± 9.11 years were examined. Depending on the presence of T2DM patients with CAD were divided into 2 groups: 1st group (n = 70) – patients with concomitant T2DM, 2nd group (n = 61) – patients with CAD without T2DM. All patients were performed coronary angiography to verify the diagnosis of coronary artery disease. Also there were assessed the levels of fractalkine and АDМА. Results: The study demonstrated that patients with CAD both with and without concomitant T2DM had significantly increased levels of fractalkine and ADMA compared with the control group (р˂0.05). In patients with hemodynamically significant stenosis of the coronary arteries, there were significantly elevated levels of fractalkine (р˂0.05), while ADMA levels were not significantly different between subgroups based on the presence of hemodynamically significant stenosis of the coronary arteries (р˃0,05). In patients with diffuse coronary artery disease with concomitant T2DM and without T2DM mellitus, the fractalkine levels were significantly higher than in patients without diffuse coronary artery lesions (р˂0.05). In patients with diffuse CAD and concomitant T2DM, there were significantly elevated levels of ADMA compared with patients without diffuse coronary vessels (р˂0.05). In patients with diffuse coronary artery disease without concomitant T2DM, there was observed a nonsignificant trend in raising the levels of ADMA in diffuse lesions of the coronary arteries (р˃0.05). Conclusions. The study results demonstrate the impact on the development and progression of atherosclerosis, endothelial dysfunction especially in patients with concomitant T2DM. The study demonstrated a trend of an unfavorable course of atherosclerosis in patients with CAD and more severe endothelial dysfunction especially in patients with T2DM that must be considered in early diagnostics in order to improve primary prevention of atherosclerotic vascular lesions, cardiovascular events, and the development of effective therapeutic strategies.