Abstract: Objective To investigate the effects of carbohydrate counting on patients with type 2 diabetes mellitus combined non-alcoholic fatty liver disease. Methods A total of 128 subjects treated only with oral drug were included from Outpatient service and Diabetes center of China and the United States of Zhejiang hospital from December 2014 to December 2016. Subjects were divided into two group randomly, The experimental group was intervened by carbohydrate counting including the preparation of a standardized diabetic meal based on the carbohydrate exchange table for patients with the help of doctors. Control group was intervened by ordinary diet. Index of Fasting blood-glucose (FPG), 2 hours postprandial blood glucose, Hemoglobin A1c (HbA1c), Triglyceride (TG), Total cholesterol (TC), High density lipoprotein cholesterol (HDL-C), Low density lipoprotein cholesterol (LDL-C), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), height, body weight and Body mass index (BMI) were compared before and after 6 months of intervention, and liver function recovery after intervention were assessed. Results After the intervention, FPG, 2 hours postprandial blood glucose, HbA1c, TG, LDL-C reduced observably, and significantly lower in the experimental group than those in the control group. After the intervention, the ALT and AST in two groups were reduced observably, and the ALT and AST in the experimental group were significantly lower than those in the control group, and the recovery of liver function in the experimental group was significantly better than that in the control group. Conclusion Carbohydrate counting method significantly ameliorated blood glucose levels, blood lipid levels and liver function in patients with type 2 diabetes mellitus combined non-alcoholic fatty liver disease.