Objective To observe the efficiency of exenatide in treatment of type 2 diabetes mellitus patients with inadequately controlled blood glucose in plateau area. Methods Eighteen type 2 diabetes mellitus patients whose blood glucose was not well controlled by metformin, sulfonylureas or insulin therapy were selected in this study. Exenatide was added to the original therapy for 3 months, and the changes of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA_1c), blood lipid levels (TG, TC, LDL-C, HDL-C), and body weight were observed. Results After 3 months of treatment with exenatide, FBG, 2hPBG, HbA_1c, body mass index, and blood lipid levels (TG, TC, LDL-C ) were significantly reduced as compared with those before treatment (P<0.05). Conclusion Exenatide can effectively control blood glucose, decrease body mass index, and improve the blood lipid level in type 2 diabetes mellitus patients living in plateau area.