Objective To explore the effect of vitamin E (VE) on subclinical atherosclerosis (AS) in patients with newly diagnosed type 2 diabetes mellitus. Methods Eighty-five newly diagnosed type 2 diabetic patients without AS were divided into two groups [VE group (n =43) and control group (n =42)] according to the random numeration table. All the patients received comprehensive intervention including the control of blood glucose, blood pressure, blood lipid and body weight and anti-platelet drugs. VE capsule (200 mg/d) was added to VE group (n =41) to evaluate its effects on the incidence of subclinical AS after one year intervention. Results Three patients withdrew during one year follow up. No significant differences of age, sex, baseline body mass index, waist to hip ratio, blood lipid, blood pressure, 24 h urinary albuminuria, insulin resistance index, high sensitive C-reactive protein level, intima-medial thickness (IMT) of common carotid artery, femoral artery and common iliac artery were found between VE group and control group (Pgt;0.05). The decrease of IMT of common carotid artery in VE group after one year intervention was more significant than that in control group (Plt;0.05), whereas the other metabolic parameters mentioned above showed no significant differences between the two groups (Pgt;0.05). The incidence of subclinical AS was significantly higher in VE group(26.8%, 11/41) than that in control group (7.3%, 3/41) (Plt;0.05). Conclusions One year VE supplementation with multifactorial intervention has no beneficial effect on subclinical AS in newly diagnosed type 2 diabetic patients.