For a study, researchers sought to analyze the purpose of the systematic review and meta-analysis was to review the current literature comparing CABG and PCI in diabetic patients and provide an up-to-date perspective on the differences between the interventions. Cardiovascular disease kills approximately 75% of diabetic patients. Previous research has shown that CABG outperforms PCI for revascularization in diabetic patients with complex coronary artery disease. Articles published between January 1, 2015, and April 15, 2021, were systematically searched in PubMed and Medline. All retrospective, prospective, and randomized trial studies comparing CABG and PCI in diabetic patients were included in this systematic review. This review included 25 studies after reviewing 1,552 abstracts. The RevMan 5.4 program was used to evaluate the data. Patients with diabetes who underwent CABG had lower 5-year mortality, major adverse cardiovascular and cerebrovascular events, myocardial infarction, and the need for repeat revascularization. Patients with PCI had lower stroke rates that were on the verge of being statistically significant. Patients receiving CABG had consistently better outcomes than those undergoing PCI in previous studies of coronary revascularization in diabetic patients. Although introducing 1st and 2nd-generation DES has narrowed the gap between CABG and PCI, CABG still outperforms PCI. More research is needed to determine the best treatment for diabetic individuals, particularly large randomized trials and retrospective studies with long-term follow-up comparing CABG with 2nd generation DES.