Purpose: To use strain rate imaging (SRI) to compare the abdominal aortic wall elasticity between patients with type 2 diabetes mellitus and controls. Methods: We measured the abdominal aorta intima-media thickness (IMT) with B-mode echography, and the anterior and posterior wall displacement (d), strain, and strain rate (SR) with SRI, in 90 patients with type 2 diabetes mellitus and 30 control subjects (group A). The patients were classified into group B (normal IMT), group C (thickened IMT), and group D (one single atheroma plaque). Results: d, strain, and SR were significantly lower in group B, C, and D than in group A (p < .05). Systolic, early-diastolic, and late-diastolic SR were lower in patients with diabetes (especially in group D) than in controls. There were significant differences in systolic SR, early-diastolic SR, and late-diastolic SR between group A and group B (p < .05). Conclusions: SRI is a noninvasive method that can demonstrate a loss in aorta wall elasticity in patients with diabetes with normal IMT. (C) 2014 Wiley Periodicals, Inc.