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Coronary heart disease (CHD) is the most common cause of death in patients with type 2 diabetes (T2DM). We aim to estimate the prevalence of CHD and cardiovascular risk factors in Chinese patients with T2DM. A total of 66,536 inpatients with diabetes treated from 2013 to 2018 were investigated, and demographic and clinical data were collected from 30,693 patients with T2DM. Age-standardized prevalence of CHD was calculated on the basis of data from the Chinese population census in 2010. Logistic regression analysis was used to analyze the risk factors. The crude prevalence of CHD was estimated to be 23.5% and a standardized prevalence was 13.9% (16.0% in men and 11.9% in women). More than half of patients with CHD have four or more of the five traditional risk factors, much higher than the 38.96% of patients without CHD (p <.01). Multivariate regression analysis showed that diabetes duration, hypertension, smoking, underweight, overweight, obesity and hypoglycaemia were significantly associated with increased risk of CHD (all p <.05). The odds ratio of CHD in patients with three, four or five defined CHD risk factors (i.e. diabetes, hypertension, dyslipidaemia, overweight or obese, and smoking) were 2.35 (95% CI 1.81–3.04), 2.96 (95% CI 2.28–3.85) or 5.29 (95% CI 4.04–6.93), compared with diabetes patients without any other risk factors. The prevalence of CHD was rather high in Chinese T2DM inpatients, and the aggregation of CHD risk factors was severe. Thus, hierarchical CHD prevention strategies based on risk factors are necessary. [ABSTRACT FROM AUTHOR]