Objective: To explore the differences between carotid intima-media thickness (CIMT) and arterial plaque risk factors in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods: A total of 347 patients with newly diagnosed untreated T2DM were recruited in this study. All participants underwent carotid ultrasonography to measure intimae-media thickness and carotid plaque. We collected information from all participants including the history of smoking, the family history of diabetes, blood pressure(BP), body mass index (BMI), blood urea nitrogen (BUN), gamma-glutamyl transpeptidase (GGT), urine albumen excretion rate (UAER), creatinine (CRE), hemoglobin A1c (HBA1C), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), cystatin (Cys-c), total cholesterol (TCH), low-density lipoprotein cholesterol (LDL-C), c-peptide (C-P), serum uric acid (SUA). A total of 347 patients were divided to two groups: a plaque group and a none plaque group. We evaluated the differences between the risk factors of CIMT and arterial plaque in patients with newly diagnosed T2DM. Results: The factors related to plaque included BMI, SBP, TC, LDL-C, HDL-C, Cys-c, age and high blood pressure history. The factors related to CIMT were SBP, HDL-C, Cr, Cys-c, age, hypertension history. Multiple stepwise regression analysis results showed that age was an independent risk factor for CIMT and SBP and BMI were independent risk factors for plaques. Conclusion: There are differences between carotid atherosclerosis and plaque risk factors in patients with newly diagnosed T2DM.