Introduction: Type 2 diabetes mellitus (T2DM) is a growing global health concern, necessitating innovative management approaches. This study investigated the impact of intermittent fasting (IF) on glycemic control and cardiovascular risk factors in T2DM patients. Methods: A 6-month, randomized controlled trial was conducted at a tertiary care hospital in Prayagraj, Uttar Pradesh, India. Two hundred adults with T2DM (HbA1c 7.0-10.0%) were randomized to either an IF intervention or standard dietary advice (control) group. Primary outcome was change in HbA1c. Secondary outcomes included changes in fasting glucose, insulin sensitivity, lipid profile, blood pressure, body weight, inflammation markers, and quality of life. Results: The IF group demonstrated significantly greater reductions in HbA1c (-0.9% vs -0.3%, p<0.001), fasting glucose (-28 mg/dL vs -10 mg/dL, p<0.001), and HOMA-IR (-1.8 vs -0.6, p<0.001) compared to the control group. Substantial improvements were observed in cardiovascular risk factors, including body weight (-4.8 kg vs -1.5 kg, p<0.001), blood pressure, and lipid profile. Quality of life scores improved significantly in the IF group. Adherence to the IF protocol was high (83% at 6 months), with no severe hypoglycemic events reported. Conclusion: Intermittent fasting is an effective and safe dietary intervention for improving glycemic control, cardiovascular risk factors, and quality of life in T2DM patients. These findings suggest that IF could be a valuable addition to current T2DM management strategies, though longer-term studies in diverse populations are needed to confirm the durability of these benefits.