Objective: To evaluate the association of retinol binding protein (RBP4) with large vascular disease in type 2 diabetes mellitus(T2DM). Methods: There were 198 T2DM patients and 100 controls in study. The patients were divided into two groups based on with or without large vascular disease,and their clinical features,metabolic indices were compared. The T2DM patients were also divided into three groups based on the concentrations of RBP4 and the occurrence of atherosclerosis(AS) were compared. The relevance of RBP4 and other parameters were analyzed by Pearson correlation analysis. The factors that can influence AS in T2DM patients were analyzed by Logistic regression analysis. Results: Serum RBP4 level was higher in T2DM than that in the controls(P < 0.05). From RBP4 low and mediam tertile group to RBP4 high tertile group,the prevalence of AS were increased from 14.5%,21.4% to 48.2%,respectively. The AS prevalence of RBP4 high tertile group was significantly higher than the other two groups. It was showed by Pearson correlation analysis that the concentrationg of RBP4 in T2DM patients was positively correlated with body mass index(BMI),systolic blood pressure(SBP),fasting blood sugar(FBS),postprandial blood sugar(PBS),fasting serum insulin(FINS) and HOMA-IR. It was showed by mutiple stepwise Logistic regression analysis that AS in T2DM patients was related to plasma RBP4,age,course of disease and LDL-C. Conclusion: AS in T2DM patients is positively correlated with plasma RBP4 levels. High plasma RBP4 may be one of independent risk factors of AS in newly diagnosed T2DM patients.