OBJECTIVE: Ranolazine a novel anti angina drug has been proved to be effective and safe in chronic stable angina and refractory angina. This study was undertaken to evaluate the safety and efficacy of ranolazine in diabetic adults with CAD and stable angina already on anti anginal medications. MATERIAL AND METHODS: Patients with documented history of both T2DM and CAD, and at least 2–months history of chronic stable angina; already on 1 or 2 antianginal medication were included in the study. Patients were randomly divided into 2 groups, Group 1 received standard medical therapy with metoprolol/diltazem and long acting nitroglycerine, and Group 2 received ranolazine 500 mg twice daily in addition to drugs in Group 1. Number of angina episode, sub lingual nitroglycerine intake per week and any side effect were recorded at least upto 8 weeks. RESULTS: 263 patients screened, 198 patients enrolled according to selection criteria and finally 156 patients were analysed. Group 1 (n– 78) received standard medications and Group 2 (n – 78) received ranolazine 500mg twice daily in addition. Baseline characteristics in both group were matching. Weekly angina frequency and sub lingual nitro–glycerine use was significantly lower in ranolazine group during weeks 2 to 8 after randomization ( p = 0.01 and 0.009 respectively). Side effects were minor in nature and small in number. CONCLUSION: Ranolazine significantly reduced angina frequency and sub lingual nitroglycerine use in type 2 diabetes mellitus and coronary artery disease with chronic stable angina.