Abstract： Objective To evaluate the efficacy and safety of rosiglitazone in type 2 diabetic patients with inefficacy of sulfonylurea,metformin and acarbose. Methods The therapeutic effects before and 3,6,9,12,24,36 months after rosiglitazone 4 mg/d were compared in 42 type 2 diabetic patients with the inefficacy of sulfonylurea,metformin and acarbose treatment for at least 3 month. Clinical variables included blood glucose,HbA1c, fasting insulin (FIns),insulin sensitive index (ISI),insulin resistance index (IRI),high sensitivity C-reactive protein (hsCRP), liver and renal functions. Results Compared with pre-treatment values, the levels of FPG, PPG, FIns, PIns, IRI, hsCRP and HbA1c were decreased, but ISI increased significantly in treatment group.Two cases (4.8%) had mild edema in the lower extremity, and diminished gradually with spironolactone treatment.No hypoglycemia and liver damage occurred. Conclusion The long-term addition of rosiglitazone maleate to the treatment of type 2 diabetic patients with the inefficacy of sulfonylurea, metformin and acarbose treatments is quite effective and safe.