Successful antihypertensive treatment plays a major role in prevention of cardiovascular events in patients with diabetes. Pharmacotherapy should be initiated in all patients with blood pressure exceeding 130/85 mmHg. Inhibition of renin-angiotensin system remains a primary goal of antihypertensive treatment, especially in case of co-existing diabetic nephropathy. In order to achieve blood pressure control (below 130/80 mmHg), vast majority of the patients would require three or more antihypertensive drugs. Blood pressure control results in greater benefits in diabetics than in patients with normal glucose tolerance. In addition to blood pressure and glucose control, other cardiovascular risk factors should also be aggressively managed.