Objective To investigate the effects of Atorvastatin combined with Aspirin on glucose metabolism, lipid metabolism and vascular endothelial function in diabetic patients with atherosclerosis (AS). Methods According to the random number table method, 80 diabetes patients with AS who were treated in Nantong Haimen People's Hospital from April 2018 to April 2021 were divided into the control group (40 cases, treated with Aspirin) and the observation group (40 cases, on the basis of the control group combined with Atorvastatintreatment), both groups were treated for 3 months. The clinical efficacy of the two groups of patients after treatment, fasting plasma glucose (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c),homeostasis model assessment-insulin resistance index (HOMA-IR), total cholesterol (TC), low density lipoprotein (LDL), triacylglycerol (TG), endothelin-1 (ET-1), nitric oxide (NO) and carotid intima-media thickness (IMT) levels before and after treatment were compared. Results After treatment, the total clinical effective rate in the observation group was 87.50%, which was higher than 67.50% in the control group; levels of FBG, FINS, HbA1c, HOMA-IR, TC, TG, LDL, ET-1 and IMT in the two groups decreased compared with before treatment, and the observation group was lower than the control group; while the serum level of NO in the two groups increased compared with before treatmentin, the observation group was higher than the control group (all P<0.05). Conclusion Atorvastatin combined with Aspirin in the treatment of diabetes with AS can effectively regulate the glucose and lipid metabolism in patients, improve vascular endothelial function, and has a significant effect, thereby delaying the progression of AS and promoting the recovery of the patient's condition.