Objective To explore the effect of platelet distribution width (PDW) on the risk of diabetic peripheral neuropathy (DPN) in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods A retrospective study was conducted on 1001 newly diagnosed T2DM patients admitted to the Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2017 to December 2021. General data, platelet-related indexes and biochemical indexes were collected. They were divided into DPN group (n=481) and non-DPN group (n=520). EmpowerStats and R3.4.3 for Windows were used for statistical analysis. Student′s t test, Mann-Whitney U test or Chi-square test was used for data comparison between two groups. Pearson correlation analysis was performed to evaluate the correlation between PDW and biochemical indexes, logistic regression analysis to analyze whether PDW was an independent factor for DPN risk, and multiple linear regression analysis to determine whether PDW was an independent factor of nerve conduction velocity. Results The PDW value was significantly higher in the DPN group than the non-DPN group [(14.58±2.26) vs (14.20±2.41) fl; P=0.01]. After adjusted for general data, platelet-related indexes and biochemical indexes, multivariate regression analysis showed that PDW was an independent risk factor for DPN, with the risk of DPN increasing by 11% per unit increment of PDW value (OR=1.11; P<0.05) and by 29% per standard deviation increment of the value (OR=1.29; P<0.05). Compared with the first quartile, PDW indicated a significantly increased risk of DPN at the third (OR=2.43; P=0.01) and fourth (OR=2.01; P<0.05) quartiles. Multiple linear regression analysis using DPN as a quantitative indicator suggested that PDW was an independent risk factor for nerve conduction velocity. Conclusion In newly diagnosed T2DM patients, PDW value is significantly higher in those complicated with DPN than those without, and it is an independent risk factor for DPN.