Abstract: Objective To investigate the clinical efficacy of Danzhi Tiaozhi Decoction combined with conventional Western medicine in patients with type 2 diabetes mellitus (T2DM) complicated with atherosclerosis.Methods A total of 70 patients with T2DM complicated with atherosclerosis who were admitted to Xuzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from June 2025 to June 2026 were enrolled. According to the random number table method, the patients were divided into two groups (n=35): a control group and an observation group. The control group received conventional Western medical treatment, while the observation group received Danzhi Tiaozhi Decoction in addition to the treatment administered to the control group. Traditional Chinese medicine (TCM) syndrome scores, glycemic indicators fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h-PG), and glycated hemoglobin (HbA1c), lipid profiles triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), carotid intima-media thickness left common carotid artery intima-media thickness (LCCA-IMT) and right common carotid artery intima-media thickness (RCCA-IMT), and inflammatory cytokine levels tumor necrosis factor-α (TNF-α), interleukin (IL)-10, IL-1β, and IL-6 were compared between the two groups before and after treatment.Results After treatment, the TCM syndrome scores in the observation group were significantly lower than those in the control group (P<0.05). The levels of FBG, 2 h-PG, and HbA1c were significantly lower in the observation group than in the control group (P<0.05). The levels of TG, TC, and LDL-C were significantly lower, whereas the HDL-C level was significantly higher in the observation group than in the control group (P<0.05). Both LCCA-IMT and RCCA-IMT were significantly lower in the observation group than in the control group (P<0.05). In addition, the levels of TNF-α, IL-1β, and IL-6 were significantly lower, while the IL-10 level was significantly higher in the observation group than in the control group (P<0.05).Conclusions Danzhi Tiaozhi Decoction combined with conventional Western medicine can further improve TCM clinical symptoms and glucose and lipid metabolism in patients with T2DM complicated with atherosclerosis, reduce carotid intima-media thickness, and improve inflammatory cytokine profiles, demonstrating favorable clinical value.