Aim To observe the changes of postprandial lipid levels and serum asymmetric dimethyl arginine levels, brachial artery endothelial function after taking fenofibrate in diabetic patients with non-alcoholic fatty liver （NAFL） and normal fasting lipid levels. Methods 110 normal fasting lipid patients with type 2 diabetes were randomly selected and divided into type 2 diabetes with NAFL and type 2 diabetes without NAFL, including 56 patients and 54 patients respectively. Both groups were measured and compared in fasting lipids, blood glucose, glycosylated hemoglobin, serum asymmetric dimethyl arginine levels, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, 4 hours after the meal and vascular endothelial function. Ultrasound was used to test brachial artery endothelial function, patients in type 2 diabetes with NAFL group were randomly divided into treatment group and control group, and the control group received conventional therapy, while the treatment group were given fenofibrateon 0.2 g daily orally treatment for 6 months on the basis of conventional therapy. After treatment review, these indicators were compared with those before treatment. Results Postprandial lipids, serum asymmetric dimethyl arginine, aspartate aminotransferase, alanine aminotransferase levels in type 2 diabetes with NAFL group were significantly higher than those in type 2 diabetes without NAFL group, and the difference was statistically significant （P<0.05）. 4 hours after treatment postprandial lipids, serum asymmetric dimethyl arginine levels in treatment group decreased, brachial artery endothelium-dependent function increased, the difference was statistically significant in the control group before and after treatment. Conclusions Fenofibrate can improve the vascular endothelial function in diabetic, NAFL patients with postprandial triglyceride hyperlipidemia.