OBJECTIVES: Little is known about the current practices of managing depression among the women with cardio-vascular conditions. Therefore, the current study was conducted to identity types of depression treatment among the women with cardio-metabolic conditions using a nationally representative survey data. METHODS: Using data of 2012 Medical Expenditure survey a retrospective cross sectional study was performed. The study sample consisted of 944 women aged 21 or older with depression and presence of any of the following cardio-metabolic conditions: hypertension, heart disease, and diabetes. Depression treatment was classified into three categories: 1) No treatment, 2) Antidepressant use only and 3) Psychotherapy with or without antidepressant. The differences in the rates of depression treatment by demographic, socio-economic, and health-status were analyzed using chi-square tests. Factors associated with depression treatment were identified using multinomial logistic regression. RESULTS:  A greater proportion of women with cardio-metabolic conditions received only antidepressant as a primary depression treatment (55%), and combination therapy (24%), whereas, 21% women did not receive any depression treatment. Women with co-existing anxiety (Adjusted odds ratio: AOR: 5.23, 95% CI: 2.37, 11.52), women with poor or fair mental health status (AOR: 4.43, 95% CI: 1.45, 13.47), and women with living in rural areas (AOR: 2.92, 95% CI: 1.21,7.05) were significantly more likely to receive psychotherapy with or without antidepressant. Whereas, women with lower than high school education and fair or poor physical health status were less likely to receive psychotherapy with or without antidepressant. Women with no usual source of care were significantly less likely to receive only antidepressant treatment. CONCLUSIONS: Nearly one forth of women diagnosed with depression and cardio-metabolic condition(s) did not receive any treatment of depression. Given the adverse prognostic outcomes of depression in women with chronic conditions, healthcare policy should be designed to improve use of active treatment in women with cardio-metabolic conditions.