Background/Aims:Some studies had suggested that neutrophil lymphocyte ratio (NLR) levels grow with the increase of nerve conduction velocity (NCV). Recently, several studies found that vitamin (D) deficiency can cause the risk of diabetes mellitus (DM) and its complication including neuropathy.The aim of our study is to evaluate the association betweenNLR, vitamin (D) deficiency and development of peripheral neuropathy in type 2 diabetic (T2DM) patients. Methods: In cross sectional study we selected a total of 60 T2DM patients.All patients underwent nerve conduction study (NCS). Then we divided them according to the results into two groups, 45 patients with DPN and 15 patients without DPN as a control group.DPN group wassubdivided according to NCS results into three groups,11 patients with mononeuropathy,4 patients with mononeuropathy multiplex and30 patients with polyneuropathy. We evaluated the effect of DPN in these patients as regarded NCS results on HbA1c levels, NLR and vitamin (D) levels. Results: There were very highly statistically significant differences between DPN group and non-DPN group as regard HbA1c and [25(OH) D] levels, (P < 0.001*** for all). There was no statistically significant difference between them as regarded NLR, (P = 0.501). Multivariate logistic regression analysis showed that, [25(OH) D] levels and duration of DM were independent risk factors for DPN, (P = 0.041*, OR = 0.88, 95% CI = 0.78-0.10), (P = 0.016*, OR = 1.54, 95% CI = 1.09-2.18) respectively. Conclusions: Vitamin (D) deficiency and HbA1c levels may be independent risk factors for development of DPN in T2DM in Minia. It is important to supply vitamin (D) appropriately and control of diabetes for preventing the generation of DPN in T2DM. NLR can't be a predictor for DPN. Abbreviations: NLR = Neutrophil lymphocyte ratio, NCS = nerve conduction study, NCV = nerve conduction velocity, DPN = diabetic peripheral neuropathy, DM = diabetes mellitus and T2DM = type 2 diabetes mellitus.