Objective: ftis study investigated how vildagliptin (a di-pepti- dyl peptidase 4 inhibitor) affects portal vein pressure and hepat- osteatosis in patients with type 2 diabetes mellitus.Methods: ftis cross-sectional study evaluated the use of specific drugs for at least 3 months on two groups of type 2 diabetes mellitus cases. Group 1 used metformin and gliclazide, Group 2 used the same amounts of metformin and gliclazide, with the addition of vildagliptin. Using Doppler ultrasound, all cases were measured for portal vein flow velocity, portal vein flow and portal vein diameter. Degree of hepatosteatosis was also recorded.Results: A total of 97 patients completed the study. fte study finished with 49 type 2 DM patients in Group1 (20 men, 29 women) and 48 patients in Group2 (20 men, 28 women. No significant difference was found in term of age, gender, BMI, HbA1c, mean arterial pressure, LDL-C, HDL-C or triglyceride levels in two groups.Portal vein flow velocity, portal vein flow volume, and portal vein diameter of all cases were measured by Doppler ultrasound in both groups. No significant difference was found between the groups (respectively p=0.92, p=0.60, p=0.92). ftere was no significant difference between groups re- garding to ultrasonographic grading of hepatosteatosisConclusion: Treating type 2 diabetes mellitus patients with vildagliptin for had no effect on portal vein hemodynamics and hepatosteatosis as assessed with Doppler ultrasound. Further long-term studies with better evaluation methods are needed to demonstrate any expected beneficial effect of vildagliptin on por- tal hemodynamics and hepatosteatosis.