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Background: Coronary artery ectasia (CAE) is dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal coronary artery. The incidence of coronary artery ectasia is distinct in different countries that can be found in 1.2% to 5% of angiographic examinations. Methods: This is a retrospective study that was conducted from September 2019 to February 2020 in Kermanshah University of Medical Sciences and the results were reported briefly. To obtain the desired articles, electronic searches were conducted in databases including the Scopus, PubMed, and Science Direct databases without time limited until October 2019. The keywords used were Coronary Artery Ectasia AND (Diabetes OR "Diabetes Mellitus"). This was done by two individuals separately and the final results were confirmed by a third person. Mixed method appraisal tool (MMAT) was used to evaluate the quality of studies. The structure of writing and the process of performing and reporting the study are based on the PRISMA checklist. Results: Based on the search strategy carried out at PubMed, Scopus and Science Direct databases, 106 studies were found, which resulted in 24 articles being analyzed based on inclusion and exclusion criteria of which three were conducted in China, 18 in Turkey and one in Sweden, Egypt, and France. Finally, 24 articles were analyzed and the results showed a direct and effective relationship between diabetes mellitus and CAE (OR=1.19, CI: 0.94, 1.51). Conclusion: Based on these results, the risk of CAE in subjects with diabetes mellitus was 19% higher than in subjects without diabetes mellitus.