Objective: To investigate the effect of dulaglutide on hepatic adipoosis and liver fibrosis in type 2 diabetes combined with metabolic-related fatty liver disease. Methods: A total of 100 patients with type 2 diabetes and metabolic-related fatty liver disease in the Department of Endocrinology of the Second Hospital of Jilin University from April 2020 to August 2020, randomly divided into a control group (insulin glargine group) and an observation group (dulaglutide group), 50 cases in each group. Clinical biochemical measures were compared between the two groups around 24 weeks of treatment. Results: At 24 weeks of treatment, significant decreases in weight and body mass index (BMI) were observed in the observed group and no significant change from baseline in the control group (all P<0.05). Both alanine aminotransferase (ALT), aspartate amino transferase (AST), liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) levels decreased compared with before the treatment, and more pronounced decreased levels in the observed group (all P<0.05). Both fasting blood-glucose (FPG), HbA1c, fasting insulin (FINS), homeostasis model assessment of insul in resistance index (HOMA-IR), triglyc-erides (TG), total cholesterol (TC) and low density lipoproteincholesterol (LDL-C) levels decreased compared to before the treatment (all P<0.05), and the levels of HOMA-IR decreased more obviously in the observation group (P<0.05); higher high density lipoprotein-cholesterol (HDL-C) levels (P<0.05) and higher time in range (TIR) in the observed group (P<0.05). Conclusion: Dulaglutide may be an effective drug in treating type 2 diabetes patients with metabolic-associated fatty liver disease to improve liver adiatosis, liver inflammation and liver fibrosis.