OBJECTIVES: Inadequate glycemic, blood pressure (BP), and low-density lipoprotein (LDL) control among persons with type 2 diabetes mellitus (T2DM) increases the risk of T2DM-related complications, which require more intensive and costly therapy. Extending on a recently-conducted study in Dubai, UAE, we assessed levels of glycemic, LDL, and BP control, and estimated the proportion of those meeting guideline targets, among a cohort of individuals treated for T2DM in Riyadh, Saudi Arabia. METHODS: Charts from 455 adults with T2DM who visited the King Fahad National Guard Hospital from October 2009 to March 2010 (enrolment period) were systematically sampled until the target (n=250) was reached. Haemoglobin A1c (HbA1c), LDL, and BP test results from enrolment to September 2011 were abstracted. The most recent test values were compared to guideline targets. The proportion of well-controlled (target met on all tests) and never-controlled (target not met on any test) subjects over the study period was calculated.  Analyses were stratified by T2DM duration. RESULTS: Forty-four percent of the cohort was male; at enrolment, mean (SD) age was 61 (13) years and mean T2DM duration was 11 (8) years. At the most recent assessment, 36 subjects (14%) had HbA1c <7%, 91 (36%) had HbA1c ≥9%, and 177 (72%) had LDL <100mg/dL. Although 109 subjects (44%) met BP targets (<130/80mmHg), 30% had BP ≥140/90mmHg. HbA1c, LDL and BP were well-controlled in 5.2%, 45.9%, and 8.4% of subjects, respectively, while 71.2%, 13.4% and 22.9% were never-controlled, respectively. The proportion of the cohort that was never-controlled for HbA1c increased with T2DM duration. CONCLUSIONS:  While rates of HbA1c control were low among subjects with T2DM, nearly half met BP targets and nearly three quarters met LDL targets. Given the increased risk of complications associated with poor control, achieving higher rates of control could reduce the burden of T2DM in Saudi Arabia.