Objectives: To study clinical characteristics of elderly hypertensive patients with type II diabetics and the relationship between risk factors with atherosclerosis (AS). Methods: 112 patients (pts) in outpatient were chosen and divided into 3 groups. There were 38 pts in hypertension group (EH), 36 pts in diabetic group (DM) and 38 pts in hypertension with diabetic group (EH+DM). 30 healthy people were selected as control group. Laboratory and carotid artery ultrasound testing were conducted in all subjects. Results: (1) The plasma levels of cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C) was higher in EH, DM and EH+DM groups than that of control group respectively, while the level of high density lipoprotein-cholesterol (HDL-C) was significantly lower than that of control group. (2) The intermedium thick (IMT) of carotid endarterium and plaque index in EH, DM or EH+DM groups was higher than that of control group respectively, especially was highest in EH+DM group. (3) The resistant index of carotid artery in EH, DM or EH+DM groups was higher than that of control group respectively, especially was highest in EH+DM group. Conclusion: Hypertension, diabetic, lipid metabolic disorder, obese, hyperuricemia and smoking are all important risk factors of AS. Hypertensive and diabetic status may accelerate the development of AS.