Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The objective of this 12‐wk crossover clinical trial was to investigate the effect of almonds on risk factors of cardiovascular disease in type 2 diabetic patients with mild hyperlipidemia. After a 2‐wk run‐in period, 24 Chinese patients were randomly assigned to either a NCEP step II diet (C) or almond diet (A) for 4 wks with a 2‐wk washout period between alternative diets. Almonds were added to the C diet to replace 20% of total daily calorie intake. Addition of approximately 60 g almonds/d increased dietary intakes of fiber, magnesium, PUFA, MUFA, and vitamin E. As compared to the baseline, the A diet led to significant decreases in body fat by 1%, HOMA‐IR by 1.1%, blood sugar by 6.7%, insulin by 7.9%, total cholesterol by 8%, and LDL‐C by 13%. Almonds also increased plasma α‐tocopherol by 20% and resistance of LDL against ex vivo oxidation by 26%. Inflammatory biomarkers, IL‐6, TNF‐α, and CRP, were ameliorated by the A diet by 14, 35, and 41%, respectively. The C diet improved some of the risk factors of cardiovascular disease but not as magnificent as the A diet. Our results suggested that incorporation of almonds into a healthy diet could decrease risk of cardiovascular disease in type II diabetes. This study was funded by the Almond Board of California and USDA Agricultural Research Service.