Abstract. The objective of this study was to provide an in-depth evaluation of the prognostic utility of the updated SCORE2 algorithm in cardiovascular risk stratification among patients with prediabetes. A cohort of 45 individuals aged 40–65 years was examined and compared with a control group, with risk assessment performed using both the SCORE and SCORE2 models. Stratification incorporated sex-specific and age-related factors, alongside lipid parameters such as non–HDL cholesterol. Our findings demonstrated that SCORE2 offers a more granular and individualized risk estimation, capturing a broader spectrum of adverse prognostic characteristics than the conventional SCORE model. Notably, significant disparities were observed in the Uzbek population, highlighting the potential ethnic variability in cardiovascular risk profiling. These results underline the superior predictive accuracy and clinical relevance of SCORE2, supporting its integration into routine clinical practice. Incorporating SCORE2 into preventive strategies for prediabetic patients could significantly improve early risk detection, guide timely interventions, and ultimately reduce the burden of cardiovascular morbidity and mortality.