New onset diabetes after transplantation (NODAT) is a frequent and serious complication after organ transplantation. Its ethiopathogenesis is complex, with interaction between intrinsic factors (older age, body mass index, individual and family history, hepatitis C virus infection) and graft related factors (immunosuppressive regimen, HLA status). NODAT is associated with an adverse effect upon patient survival, with an increased incidence of infectious and cardiovascular complications. This study aimed at identifying risk factors for the development of NODAT and its effect on premature aterosclorsis. An observational study of 227 patients with a mean age of 42.2 years (61.1% were men); all were receiving cyclosporine and steroids and MMF. Data collected on a routine visit 1-24 months after kidney transplantation. Diabetes was defined according to ADA/WHO guidelines. The carotid intimae-media thickness (CIMT) of diabetic patients were compared with age & sex matched non diabetic post RTX patients and compared with baseline. NODM developed in 15% after a median interval of 1.6 months. Risk factors for the development of NODAT were older age(p < 0.01), heavier weight at time of transplantation (p < 0.01) and time of diabetes onset, higher plasma glucose within the first seven d post-transplant (p < 0.01) and use of high dose of steroids and CMV infection were risk factors of NODAT. There was a significant deference between CIMT of NODAT patients and non diabetics, p<0.001 . Conclusion: NODM is associated with certain RFs and CIMT in renal transplant recipients.