Background. Diabetic peripheral neuropathic pain (DPNP) is a common chronic pain condition affecting diabetic patients and has growing importance because of the increasing prevalence of patients with type 2 diabetes mellitus. Pain is the most troublesome symptom of DPNP, increasingly recognized as an important and independent feature of DPNP. This meta-analysis aims to compare the efficacy and safety of duloxetine and gabapentin in the treatment of diabetic peripheral neuropathic pain (DPNP) and therefore to provide evidence-based medicine for clinical treatment. Methods. Relevant randomized controlled trials on duloxetine versus gabapentin for DPNP were searched from PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and Chinese Biomedical Literature Database from database inception to October 2021. The data were analyzed by RevMan 5.3 software. Results. Seven studies were included. The results showed that, at the end of the study, duloxetine was significantly superior to gabapentin in terms of the incidence of adverse reactions (RR = 0.59, 95% CI: 0.45–0.79, P  < 0.01), sleep interference score (SMD = −0.35, 95% CI: −0.63 to −0.08, P  < 0.05), but no significant differences in VAS score (SMD = −0.14, 95% CI: −0.31–0.03, P  > 0.05), overall response rate (RR = 1.05, 95% CI: 0.92–1.20, P  > 0.05), and clinical global impression of change (SMD = 0.07, 95% CI: −0.20–0.35, P  > 0.05). Conclusion. Compared with gabapentin, duloxetine has no obvious advantage in the treatment of diabetic peripheral neuralgia, but it has less side effects and significantly higher safety.