Background: Cardiovascular disease (CVD) remains the leading global cause of mortality, and Type 2 Diabetes Mellitus (T2DM) significantly elevates CVD risk through metabolic and vascular complications. Objective: To assess the effectiveness of family medicine interventions in reducing cardiovascular risk factors and events among T2DM patients in Alahsa during the December 2015 to September 2016 period. Method: This retrospective cohort study included 3,000 T2DM patients from Alahsa. Data on glycemic control, lipid profiles, blood pressure, pharmacological adherence, and CVD event rates were analyzed. Patients were grouped into those receiving comprehensive family medicine care and standard care. Statistical comparisons were performed to evaluate outcomes. Results: Among the 3,000 patients, 65% achieved glycemic control (HbA1c <7%) with family medicine-led care, compared to 47% in the standard care group. LDL cholesterol levels reduced by 30%, and HDL levels increased by 18% in patients receiving lipid-focused interventions. Blood pressure control (<140/90 mmHg) was achieved in 78% of hypertensive patients, compared to 61% in the standard care group. Adherence to cardioprotective therapies, including SGLT2 inhibitors and GLP-1 receptor agonists, improved to 88%, resulting in a 25% reduction in major cardiovascular events (from 16% to 12%). Patients receiving family medicine care had a 32% lower relative risk of CVD complications (p<0.01). Conclusions: Family medicine significantly improves cardiovascular outcomes in T2DM patients by enhancing risk factor management and adherence to therapies, highlighting its essential role in primary care.