Objective: Patients with type 2 diabetes have an increased tendencyto develop hepatosteatosis. The effects of drugs used to treatdiabetes on the liver, regardless of the disease, are unknown.Theaim of this study was to investigate the effects of vildagliptin, adipeptidyl peptidase-4 inhibitor, on the portal vein pressure andhepatosteatosis in patients with type 2 diabetes in the 18 monthsof follow-up.Methods: Patients to whose treatment vildagliptin was added whilethey were on therapy with metformin and gliclazide for type 2 DMthe vildagliptin group were included. As the control group, 49patients with type 2 DM treated with metformin and gliclazide wereincluded. These patients were followed up for 18 months. Thesepatients were followed for 18 months and their pre-treatment andpost-treatment examinations were repeated. Portal vein diameter,portal vein flow and portal vein velocity were calculated to evaluateportal vein pressure with the same Doppler ultrasonography (US)by the same radiologist. In the same session, the liver steatosis stageof all patients was evaluated with US and recorded. The data beforetreatment and the data 18 months after treatment were compared.Results: Nineteen patients completed the study in the study group,while 10 patients completed the study in the control group. Asignificant increase in portal vein flow velocity and vein diameter wasfound in the study group when portal vein parameters were comparedbefore and after treatment (p=<0.001, p=0.035, respectively). There was no significant difference in portal vein flow volume. In thecontrol group, no significant changes in flow velocity and flowvolume were detected, although there was a significant increase inportal vein diameter (p=0.04, p=0.07, p=0.14, respectively). Therewere no significant changes in vildagliptin group before and aftertreatment in terms of hepatosteatosis (p=0.41). There were nosignificant changes between control and study groups in terms ofhepatosteatosis after 18 months of treatment.Conclusion: As a result, we did not find any significant changesin the parameters of portal vein pressure with vildagliptin use. Wethink that vildagliptin has no effect on hepatosteatosis.