Asymmetric dimethylarginine (ADMA) is now well established as a major risk factors for cardiovascular disease (CVD) impact upon endothelial function by decreasing nitric oxide (NO°) bioavailability. Asymmetric dimethylarginine, an endogenous analog of L-arginine, is able to inhibit the activity of endothelial-nitric oxide synthase (eNOS), promoting endothelial dysfunction. Prediabetes is characterized by a reduced endothelium-dependent vasodilation and increased ADMA levels. Asymmetric dimethylarginine is strongly associated with micro- and macrovascular diabetic complications. Asymmetric dimethylarginine activity is strongly correlated with CVD in prediabetes. Materials and methods: This study was a cross-sectional, descriptive type of study. In total, 815 participants were involved in this study, out of which 250 suffered from type II diabetes and 265 were prediabetic patients. 290 controls were involved from hospital OPD. Biochemical parameters including fasting plasma sugar, postprandial plasma sugar (after 2 hours of 75 g oral glucose), fasting lipid profile (serum total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, triglycerides (TG), high-density lipoprotein (HDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol) were done by enzymatic methods. The quantitative sandwich enzyme immunoassay technique was used to determine plasma ADMA level by using commercially available enzyme-linked immunosorbent assay. Results: The level of ADMA in prediabetes was 0.55 ± 0.11 and of type II diabetes was 0.70 ± 0.14 compared with controls (0.41 ± 0.14). p value was <0.05, which was significant. In the present study, there was a significant increase in serum TC, TG, LDL, VLDL, TG/HDL, and LDL/HDL ratio compared with those of normal healthy subjects, while HDL was significantly decreased in prediabetic as compared to normal healthy subjects. Conclusion: The current study shows that increased ADMA levels can indicate the risk of CVD in prediabetic stage. Prediabetes people are under risk of CVD and type II diabetes. Individuals who are prediabetic are at risk of CVD and type II diabetes. The evaluation of the ADMA levels may improve the early diagnosis of CVD of prediabetes.