OBJECTIVES: To assess ten year cardiovascular disease (CVD) risk in newly diagnosed type 2 diabetes mellitus (duration of diagnosis ≤ 6 months) patients using Framingham risk score(FRS) and United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine in a public tertiary care hospital in North India and to assess the agreement between both the risk scores. METHODS: This is a prospective, observational, questionnaire based study. Patients aged 18-70 years of either sex were recruited and data were collected by oral interview and clinical records of patients after obtaining informed consent from patients. Ten year CVD risk was calculated for 324 patients using FRS and UKPDS Risk Engine. FRS uses participant age, sex, total cholesterol, high-density lipoprotein cholesterol, smoking status, blood pressure and presence or absence of diabetes. UKPDS Risk Engine, a diabetes specific algorithm; uses HbA1c and ethnicity of the patient in addition, for assessing ten year CVD risk.  RESULTS: Out of 324 patients [males (n) = 149; females (n) = 175], using Framingham risk score 19.1% are estimated with high risk, 23.1% as moderate risk, 26.2 as low risk and 31.5% as very low risk. The corresponding figures using UKPDS risk engine are 7.7%, 13.9%, 10.8% and 67.6%, respectively. Inter- rater agreement assessed using weighted Kappa statistic showed a poor agreement between both scoring systems with a k value of 0.18 (95% CI 0.12-0.23) CONCLUSIONS: Framingham risk score overestimated the ten year CVD risk compared to UKPDS Risk Engine. As till date, CVD risk score development and comparison studies were limited to European and American subjects, this study presents a valuable contribution regarding Indian type 2 diabetes patients.