Objective <p>Type 2 diabetes causes changes in the structure and functions of the major salivary glands. The aim of this study is to evaluate the dimensional measurements, echogenicity, and fractal dimension (FD) of bilateral major salivary glands in patients with type 2 diabetes mellitus (DM) on ultrasonography (US) and compare them with healthy individuals.</p> Methods <p>The study included US images of 36 patients with type 2 DM and 36 healthy individuals. The superoinferior (SI), anteroposterior (AP), and mediolateral (ML) dimensions of the major salivary glands were measured, echogenicity was classified, and FD was calculated. Dimensional measurements, FD, and echogenicity comparisons between groups were analyzed.</p> Results <p>Dimensions of SI, AP, and ML were found statistically higher in the patient group than in the control group (<i>p</i> &lt; 0.05). In the parotid gland, the isoechoic type was significantly more common in the patient group (<i>p</i> &lt; 0.05). Although no statistically significant relationship was observed, in the submandibular and sublingual glands, isoechoic type was more frequent in the patient group. FD values were found to be higher in the patient group compared with the control group for all glands and a statistically significant relationship was observed in the sublingual gland (<i>p</i> &lt; 0.05).</p> Conclusion <p>Type 2 DM is a disease that changes the salivary gland structure, but to confirm these results, new studies are needed in which disease severity/HbA1c levels, drug doses and disease duration are known and can be associated with clinical data.</p>