Background: Cardiovascular autonomic neuropathy (CAN) is a serious complication of diabetes mellitus which is generally neglected by the treating doctor as well as patient. The objective of the study was to study cardiovascular reflexes in diabetic autonomic neuropathy at a tertiary care hospital.Methods: Present hospital based cross sectional study was conducted at Osmania Medical College and General Hospital which is a tertiary care hospital for a period of two years among 80 known cases of diabetes. Institutional Ethics Committee permission was obtained, and informed consent was taken.Results: In the present study, maximum i.e. 60% were males. Postural hypotension was noted in the long-standing diabetics. The average duration of diabetes showing postural hypotension was 13.5 years. The highest recorded postural hypotension was 50 mmHg. 30% showed the autonomic damage. 45% showed normal variation. 25% showed border line variation. 30% had abnormal response (A Valsalva ratio of 1.10 and less is abnormal). 35% showed abnormal response (If the ratio is 1.00 or less, vagal damage is probably present).Conclusions: The average duration of diabetes showing postural hypotension was 13.5 years. The highest recorded postural hypotension was 50 mmHg. 25% of the patients had blood pressure fall of 30 mmHg and more. In 55% of the cases, the fall was between 10-20 mmHg. 30% showed the autonomic damage. 30% had abnormal Valsalva ratio.