Aim To evaluate the relation between non-high density lipoprotein cholesterol （non-HDLC）/HDLC and early carotid plaque in type 2 diabetes patients. Methods 1021 type 2 diabetes patients without history of cardiovascular disease were retrospectively analyzed. Carotid plaque and plaque area were measured by B ultrasound. The general data, duration of diabetes, glycosylated hemoglobin, low density lipoprotein cholesterol （LDLC）, HDLC, non-HDLC and the lipid ratios were compared in the group with carotid plaques and without plaques. The relation between serum lipid parameters and carotid artery plaque was analysed. The prediction power of the lipid parameters on carotid artery plaque were analysed by receiver operating characteristic curve （ ROC ）. In the group with carotid plaques, the correlation of the lipid parameters and plaque area were anayzed. Results The male ratio, age, duration of diabetes, systolic blood pressure, non-HDLC levels, non-HDL/HDLC, total cholesterol（TC）/HDLC and LDLC/HDLC were significantly higher in the group with paques than the group without plaques. However, the HDLC level was significantly lower in the group with plaques than the group without plaques. The difference of the above was statistically significant （P<0.05）. Logistc regression analysis showed that non-HDLC levels, non-HDLC/HDLC, TC/HDLC and LDLC/HDLC were independent risk factors for carotid plaque （P<0.05）. There were no correlation between LDLC levels and carotid plaques after adjustment for confounding factors. The area under ROC curve of non-HDLC/HDLC and other lipid parameters were compared: non-HDLC/HDLC was higher than that of LDLC/HDLC, TC/HDLC, but the difference was close to statistical significance （P0.052 and 0.058）. Non-HDLC/HDLC was significantly higher than that of HDLC and LDLC （P<0.001）. In the group with plaques, multiple regression analysis showed non-HDLC/HDLC and LDLC/HDLC were the independent impact factors （P<0.05） for plaque area. Non-HDLC and TC/HDLC were in no correlation with plaque area after adjusting for confoundings. Conclusion Non-HDLC/HDLC is a useful lipid parameter to assess the risk of early carotid plaque and plaque area in type 2 diabetes.