Objective To investigate the relationship between ankle-brachial index (ABI) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus(T2DM). Methods ABI was determined in 427 patients with T2DM by Doppler ultrasound, and the patients were divided into group A (ABI≥0.9) and group B (ABI＜0.9). The sensory nerve conduction velocity (NCV), latent period and amplitude of posterior tibial nerve in all patients with T2DM were determined by electromyography. These indexes were compared between the two groups, and their relationships were analyzed by linear correlation analysis and multiple linear regression. Results There were 115 patients with ABI＜0.9 in group B, accounting for 26.9%. The nerve conduction velocity [left NCV: (30±8) vs (32±7) m/s, right NCV: (29±6) vs (33±7) m/s, P＜0.01] and amplitude [left amplitude: (10±12) vs (15±16) mV, right amplitude: (9±7) vs (14±13) mV, P＜0.01] of posterior tibial nerve were lower in group B than in group A, and the latent period [left latent period: (8.2±2.0) vs (7.4±1.4) ms, right latent period: (8.3±1.7) vs (7.4±1.3) ms, P＜0.01] of posterior tibial nerve were higher in group B than in group A. ABI was negatively correlated with latent period and positively correlated with amplitude of posterior tibial nerve in T2DM patients. After adjustment with a series of confounding factors such as age, course of disease, body mass index (BMI), systolic blood pressure, total cholesterol, low density lipoprotein cholesterol (LDL-C), serum creatinine, NCV and amplitude, multivariate analysis results demonstrated that ABI was associated with age, LDL-C, NCV and BMI. Conclusions In patients with T2DM, peripheral artery disease is a potentially important influencing factor for diabetic peripheral neuropathy.