Background. VEGF seems to have a protective role on cardiac microcirculation, but no data are available on its action on cardiac function and morphology in diabetic patients. We sought to test the hypothesis that circulating VEGF levels could influence the cardiac performance in type 2 diabetic hypertensive patients. Methods. We studied 30 patients with type 2 diabetes and hypertension, without severe cardiac, retinal, renal and peripheral vascular damage. Ten non-diabetic hypertensive patients represented the control group. VEGF plasma levels (ELISA) and echocardiographic parameters were evaluated. Results. Diabetic patients had VEGF plasma levels higher than hypertensive non-diabetic subjects [median 82 (IQR 12–190) vs 50.5 (IQR 28–77) pg/mL, p=0.05]. Simple linear regression analysis showed that VEGF levels are related to relative wall thickness (RWT) and both endocardial and midwall systolic parameters in the diabetic patients. Multiple linear regression analysis showed that RWT and ejection fraction (EF) were the only independent correlates of VEGF (r2=0.274, p=0.03; p=0.05, respectively). Conclusions. Our data showed that high VEGF plasma levels are associated to a better systolic function in diabetic hypertensive patients with cardiac remodeling. VEGF may play a role in the improvement of cardiac performance in diabetes.