Background: Gastroesophageal Reflux Disease (GERD) and type 2 diabetes have impacted countries' economies, healthcare systems, and patients' social life. Much modern literature discusses the prevalence of GERD in type 2 diabetes mellitus, and few studies assess the severity of GERD in type 2 diabetes mellitus. Objective: The aim of the current work was to assess the severity of GERD in type 2 diabetic patients compared to non-diabetic patients. Patients and Methods: This cross-sectional study included a total of 194 patients aged 18 to 65 years with GERD attending at the Gastrointestinal Endoscopy Unit, Internal Medicine Department, Zagazig University Hospitals. All patients were diagnosed with GERD by endoscopy and were presented with esophageal and non-esophageal manifestations. Patients were divided into two groups; Diabetic Group included 87 patients with type 2 diabetes, and Group 2 (control) included 107 nondiabetic patients served as control. Results: Typical GERD symptoms were 37.6% of cases with highly statistically significant differences between the two groups (P-value = 0.000). Heartburn was a common symptom in diabetic patients (47%), with a highly statistically significant difference between the two groups. Epigastric pain (30%) was most common in non-diabetic patients. The most common extra-esophageal manifestations in type 2 diabetic patients were hoarseness (15%) and chest pain (13%). In contrast, dysphagia (13%) was common in non-diabetics. The GERD severity was mild grade (grade A, 80%), with a statistically significant difference between the two groups. However, comparing other grades between the two groups showed significantly more severe in the type 2 diabetic group. Conclusion: It could be concluded that type 2 diabetes mellitus patients tend to have more gastroesophageal reflux disease severity than non-diabetics. However, most patients of the two groups presented with mild endoscopic severity of gastroesophageal reflux disease.