Objective To investigate the relationship between serum uric acid/high density lipoprotein cholesterol ratio(UHR) and brachial-ankle pulse wave velocity in type 2 diabetes, and investigate the effect of UHR on peripheral arterial elasticity. Methods A total of 235 T2DM patients who were hospitalized in Endocrinology Department of Chengdu Second People's Hospital from June 2023 to December 2023 and received baPWV examination during hospitalization were enrolled. According to the results of baPWV, 61 patients in baPWV normal group(baPWV < 1400cm/s) and 174 patients in baPWV elevated group(baPWV≥1400cm/s) were divided into two groups, and the differences in clinical indicators between the two groups were compared. Results Compared with the normal baPWV group, patients with elevated baPWV had longer T2DM course and older age, higher carotid plaque prevalence, SBP, DBP, FPG, 2h-PG, UA and UHR levels, and lower hip circumference, FT3, FT3/FT4 and HOMA-β levels. The difference was statistically significant(P<0.05). Logistic regression analysis indicated that SBP and UHR were independent risk factors for elevated baPWV in T2DM patients, and hip circumference was a protective factor. Conclusion SBP and UHR are independent risk factors for elevated baPWV in type 2 daibetes, and hip circumference is a protective factor. In the comprehensive management of T2DM patients, attention should be paid to the control of blood pressure, and patients with elevated UHR should be timely assessed for arterial status and early intervention, so as to reduce the risk of vascular events in type 2 diabetes