Aim: To investigate the association of sarcopenia with cardiovascular disease (CVD)incidence in people with type 2 diabetes.Materials and Methods: A prospective cohort study with 11 974 White EuropeanUK Biobank participants with type 2 diabetes, aged 40-70 years, included. Sarcope-nia was defined based on the European Working Group on Sarcopenia in Older Peo-ple as either non-sarcopenic or sarcopenic. Outcomes included CVD, stroke, heartfailure (HF) and myocardial infarction (MI). The association between sarcopenia andthe incidence of outcomes was investigated using Cox proportional hazard modelsadjusted for sociodemographic and lifestyle factors. The rate advancement periodwas used to estimate the time period by which CVD is advanced because ofsarcopenia.Results: Over a median follow-up of 10.7 years, 1957 participants developed CVDs:373 had a stroke, 307 had an MI and 742 developed HF. Compared with non-sarcopenia, those with sarcopenia had higher risks of CVD (HR 1.89 [95% CI 1.61;2.21]), HF (HR 2.59 [95% CI 2.12; 3.18]), stroke (HR 1.90 [95% CI 1.38; 2.63]), andMI (HR 1.56 [95% CI 1.04; 2.33]) after adjustment for all covariates. Those with sar-copenia had CVD incidence rates equivalent to those without sarcopenia who were14.5 years older. Similar results were found for stroke, HF and MI.Conclusions: In people with type 2 diabetes, sarcopenia increased the risk of devel-oping CVD, which might occur earlier than in those without sarcopenia. Therefore,sarcopenia screening and prevention in patients with type 2 diabetes may be usefulto prevent the complications of CVD.