ABSTRACT. This study aims to investigate the value of highresolution color Doppler ultrasonography (HR-CDU) in the evaluation of lower-extremity vasculopathy (LEV) and its related risk factors in type 2 diabetes mellitus (T2DM) patients. Two hundred forty T2DM patients were selected, who underwent lower-extremity arterial HR-CDU. The patients were divided into the LEV group (V group) and the nonvasculopathy group (A group). The V group was then divided into the mild (B group), moderate (C group), and severe (D group) subgroups. The relevant clinical parameters were simultaneously recorded. The results showed that the lesion-positive detection rate of HR-CDU was significantly higher than that of clinical examination. The age, disease duration, smoking history, blood pressure, blood sugar, fibrinogen (FIB), C-reactive protein (CRP), uric acid (UA), and urinary albumin excretion (UAE) in the V group were higher than in the N group. In the logistic regression analysis, smoking history, age, disease duration, FIB, UA, and fasting blood glucose were independent risk factors of T2DM LEV. The incidence of LEV in T2DM patients increased significantly with increasing age, UA, FIB, CRP, UAE, disease duration, and smoking history, and the vasculopathy level became more severe. In conclusion, age, disease duration, smoking history, blood pressure, blood sugar, FIB, CRP, UA, and UAE are the related risk factors of LEV in T2DM patients.