Objectives: Cardiovascular risk can be predicted using lipid ratios such as the atherogenic index which is defined as the base 10 logarithm of the ratio of plasma triglyceride (TG) to high density lipoprotein cholesterol (HDL-C)-it is a useful prognostic parameter for guiding timely interventions and has also been employed as a predictor of cardiovascular risk. However, this is rarely used in the clinical practice in developing countries including Nigeria. Methods: This study was a hospital-based cross-sectional study of 382 hypertensive and diabetic patients attending outpatient clinics of a tertiary hospital in Nigeria. Atherogenic risk profile, was categorized as low risk (<0.1), intermediate risk (0.1-0.24), and high risk (>0.24). Predictors were established using regression analysis. Level of significance was set at p-value of <0.05 and 95% confidence interval. Results: The mean age of participants was 56±12 years, 31.4% of participants had high atherogenic risk. This was higher among female patients (60.0%). Participants with high TC, high LDL, uncontrolled blood pressure had odds of 1.64, 1.43 and 1.17 times of developing high atherogenic risk respectively. Conclusion: A significant proportion of participants in this study population were at risk of developing atherosclerosis. Key identified populations at risk of CVD should be considered for routine artherogenic assessment.