Abstract: OBJECTIVE To observe the effect of acarbose on carotid intimamedia thickness (IMT) in the elderly patients with impaired glucose tolerance (IGT). METHODS 120 cases of elderly patients with IGT were divided into two groups: 60 cases of oral Acarbose 50 mg, 3 times per day, continued one year,60 cases of no medication,all patients were followed up for 1 year. RESULTS Plasma glucose after steamed bread meal 2 hours (2hPG) was lowered obviously by treated for 4 weeks(P<0.01).After 1 year HbA1c was reduced(P<0.05).The average IMT increased in the treatment group was significantly lower than that of control group(P<0.05). CONCLUSION Acarbose reduced 2hPG in the elderly patients with IGT , long-term treatment can reduce HbA1c and delay the development of arteriosclerosis.