Aim To explore the relationship between postprandial hyperlipidemla and carotid and cornary atheroslerosis in type 2 diabetic patients. Methods According to blood triglyceride level(fasting TG and TG4h),ninety type 2 diabetic patients were enrolled and divided into three groups,including group I(TG4h ≤2.0 mmol/L),group Ⅱ(TG4h>2.0 mmol/L) and group Ⅲ(high fasting blood triglyceride level).All patients' fasting blood glucose,postprandial two hours blood glucose(PBG2h),fasting blood insulin,glycosylated hemoglobin(HbA1c),total cholesterol(TC),total triglyceride(TG),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),body mass index(BMI)and waist hip ratio(WHR)were measured.Meanwhile,they were detected by carotid color Doppler sonarography and coronary angiography.All results were analyzed in statistic method. Results Carotid artery intima-media thickness,carotid artery plaque,carotid artery plaque score,macrovascular complications in group Ⅱ(1.11±0.20 mm,80.6%,3.50±0.44 mm,54.8%) and group Ⅲ(1.12±0.73 mm,83.3%,3.52±0.52 mm, 62.5%)were significantly higher than those in groupⅠ(0.73±0.22 mm,40%,2.60±0.25 mm,20%) p<0.01,while carotid artery intima-media thickness (IMT)in group Ⅱand group Ⅲ were similar(p<0.05).The Vmax,Vmin,Vmin,PI and RI had no difference for the three groups(p<0.05).The double and triple vessel lesion in group Ⅱ(29%,16.1%) and group Ⅲ(29.2%,16.7%) were significantly higher than those in group Ⅰ(11.4%,2.9%) p<0.01;the single vessel lesion in group Ⅱand group Ⅲ were similar(p<0.05).The single vessel lesion、 the double vessel and triple vessel lesion in group Ⅱand group Ⅲ were similar(p<0.05).Through multiple correlation analyzing, we found carotid artery's IMT was significantly and positively correlated with TG4h,BMI and WHR,which stated that TG4h,BMI,WHR were dangerous factors of arteriosclerosis(p<0.01),r=0.642,0.55472,0.5482. Conclusions Either postprandial hyperlipidemia or fasting hyperlipidemia atherosclerosis correlates with arteriosclerosis in type 2 diabetic patients.