Objective: We aimed to investigate the characteristics of type 2DM patients that show the discrepancy between carotid intima media thickness (IMT) and coronary artery status. Methods: We used the multidetector coronary computed tomography (MDCT) data collected from subjects with type 2 diabetes who did not have a history of cardiovascular disease or angina symptoms. Before and after IMT data close to MDCT date was also collected. Average IMT less than 1mm and no plaque was defined as without significant IMT lesion. Subjects who showed non-significant IMT lesion but had coronary artery disease (CAD) (≥ 50% stenosis of at least one of the coronary artery) were analyzed. And subjects who had the significant IMT lesion but no CAD were also analyzed. Results: Among the total 739 subjects, 333 subjects showed non-significant IMT lesion. Among them, 99 patients (29.7%) had CAD without significant IMT lesion. Compared with 234 subjects (70.3%) who had no CAD and non-significant IMT lesion, subjects who had CAD showed longer DM duration (13.3 ± 9.7 vs 9.4 ± 7.7 years, P-value < 0.001) and had tendency of older age (61.4 ± 10.0 vs 59.4 ± 9.3 years, P-value = 0.085). Among the 406 subjects who had IMT lesion, 202 subjects (49.8%) had CAD and 204 subjects (50.2%) didn’t. Subjects who had no CAD with IMT lesion showed shorter DM duration (11.9 ± 9.0 vs 15.5 ± 9.6 years, P-value < 0.001) and had tendency of lower SBP (125.4 ± 14.6 vs 128.1 ± 15.3 mm Hg, P-value = 0.074). Conclusion: Regardless of the IMT result, duration of diabetes is the independent risk factor for predicting the probability of cardiovascular disease.