Abstract: Objective To investigate the changes of serum levels of free fatty acids and high-sensitivity C-reactive protein in patients with type 2 diabetic mellitus and coronary heart disease. Methods 103 cases of type 2 diabetic mellitus with coronary heart disease, 105 cases of type 2 diabetic mellitus without coronary heart diseases and 51 health controls were selected into this study. The levels of serum free fatty acids were measured with enzymatic colorimetric method and high-sensitivity C-reactive protein were measured with immunoturbidimetry. Serum free fatty acids and high-sensitivity C-reactive protein and other factors related to type 2 diabetic mellitus and coronary heart disease were analyzed with multiple stepwise logistic regressive analysis. Results The serum levels of free fatty acids and high-sensitivity C-reactive protein in type 2 diabetic mellitus with coronary heart disease were significantly higher group than those in the type 2 diabetic mellitus without coronary heart disease and normal controls (P<0.01). The serum free fatty acids and high-sensitivity C-reactive protein were related significantly with type 2 diabetic mellitus with coronary heart disease. Conclusion The serum free fatty acids and high-sensitivity C-reactive protein are important risk factors of type 2 diabetic mellitus with coronary heart disease.