Background: Despite the wide acceptability of fasting lipid profile in practice, emerging evidence suggests that random lipid profile might be a convenient alternative for lipid measurement. The objective of the present study was to compare the fasting and random lipid profile among subjects with T2DM.Methods: The present cross-sectional study included 1543 subjects with T2DM visiting several endocrinology outpatient clinics throughout Bangladesh from January to December 2021. The fasting lipid profile was measured in the morning following 8-10 hours of overnight fasting, and the random lipid profile was measured at any time of the day irrespective of the last meal. The values of fasting and random lipids were compared using the Wilcoxon signed-rank test and Spearman rank correlation coefficients.Results: In this study, a good level of correlation was observed between fasting and random lipid levels [r = 0.793, p <0.001 for triglyceride (TG), r = 0.873, p <0.001 for low-density lipoprotein cholesterol (LDL-C), r = 0.609, p <0.001 for high-density lipoprotein cholesterol (HDL-C), and r = 0.780, p <0.001 for total cholesterol (TC)]. In addition, TG and TC levels increased by 14% and 0.51%, respectively, in the random state compared to the fasting state (p- <0.05), while LDL-C levels decreased by 0.71% (p value 0.42). No change was noticed in the HDL-C level. The difference between fasting and random lipid profile was similar according to age, sex, BMI, glucose-lowering drug(s), and lipid lowering therapy.Conclusions: Random lipid profile correlates significantly with fasting lipid profile with little difference. Hence, it might be a reliable alternative for fasting lipid profile in T2DM patients.