Background: The burden of diabetes mellitus (DM) is on the rise in low-income countries and many countries in sub-Saharan Africa are experiencing an epidemic of diabetic complications. Patients who suffer from DM with hyperuricemia have a significantly increased risk of diabetic complications. There is paucity of data on the burden of hyperuricemia in Uganda. This study was aimed at determining the prevalence of hyperuricemia, its associated factors, and its effect on the risk of coronary artery disease among out-patients with Diabetes Mellitus in Uganda. Methods: A cross-sectional study was conducted at Fort Portal Regional Referral Hospital between May and August 2022 which recruited diabetic participants. A questionnaire was used to obtain patient data. Laboratory investigations were done including serum uric acid levels. SPSS version 22.0 was used to analyze the data. Results: Of the 210 participants, the majority were female (61.4 %) with a mean age of 55.34(12.36) years. The prevalence of hyperuricemia was 38.57%. The factors that were independently associated with hyperuricemia were: the presence of systolic hypertension (p=0.047), use of furosemide (p=0.003), alcohol intake (p=0.014), impaired estimated glomerular filtration rate (p<0.001) and abnormal total cholesterol (p<0.001). There was a significant positive moderately strong correlation between uric acid levels and the Framingham risk score (FRS) (p=<0.001). Conclusion: Regular screening for uric acid levels in diabetic patients should be done to improve health outcomes through early diagnosis and treatment. Diabetic patients should also be educated on the effect of alcohol intake and advised on cessation.