This study aimed to evaluate whether there was any association between carotid artery ultrasound parameters and the results of stress myocardial single photon emission computed tomography (SPECT) and coronarography in 126 asymptomatic type 2 diabetic patients. Thirty-three (26%) patients had an abnormal SPECT result, 33 (26%) had an intermediate result and 60 (48%) had a normal result. Carotid ultrasound demonstrated a significant association between an abnormal SPECT result and the presence of atheroma plaques and reduced distensibility of the common carotid artery, but there was no association with intima-media thickness (IMT). In 38 diabetic patients who agreed to be examined with selective coronarography, significant coronary stenosis (at least one stenosis > or = 70%) was diagnosed in 22 (58%) patients. A significant association was demonstrated between significant coronary stenosis and the presence of atheroma plaques; however, there was no association between stenosis and reduced distensibility of the common carotid artery or IMT.