Aim To explore the relationship between atherosclerosis and serum interleukin-10 (IL-10), adiponectin in type 2 diabetes patients with hyperuricemia. Methods The blood uric acid (UA), serum interleukin-10 (IL-10), adiponectin and other indicators were detected in type 2 diabetes patients with high uric acid and artery atherosclerosis sclerosis (65 cases, high uric acid group), type 2 diabetes patients with artery atherosclerosis sclerosis (68 cases, normal uric acid group), normal control group (30 cases), respectively. And the relationship between the above indexes and artery atherosclerosis were analysed. Results Serum IL-10 levels was significantly lower in high uric acid group, normal uric acid group than that in normal control group, and it was lower in high uric acid group than that in normal uric acid group Serum adiponectin levels was significantly lower in high uric acid group, normal uric acid group than that in normal control group, and it was lower in high uric acid group than that in normal uric acid group Correlation analysis showed that intima-media thickness (IMT) was negatively correlated with IL-10 and adiponectin, and positively correlated with homeostasis model assessment insulin resistance index (HOMA-IR), UA. Multiple linear stepwise regression analysis showed that IL-10, adiponectin, UA, triglyceride (TG), low density lipoprotein cholesterol (LDLC), HOMA-IR, systolic blood pressure (SBP) and dglycosylated hemoglobin (HbA1c) entered the regression equation. Conclusion Reduction of serum IL-10, adiponectin levels is closely related to insulin resistance, hyperuricemia, which participate in the development of diabetic atherosclerosis.