Objective The aim of this study was to assess the association between plasma leptin levels and the chronic complications in type 2 diabetic patients. Methods The aim of this study was to assess the association between plasma leptin levels and the chronic complications in type 2 diabetic patients. Results The mean age of subjects was 62.2±13.1 years. The mean DM duration, HbA1C, and body mass index (BMI) was 10.3±8.7 years, 8.6±2.3%, and 24.4±4.0 kg/m2, respectively. Plasma leptin levels in female with type 2 DM were higher than in male with type 2 DM. In female, plasma leptin levels were significantly higher in subjects with cerebrovascular disease (CVD) than those without CVD. However, there were no significant differences between other micro- and macrovascular complications in female. In a multivariate analysis, there was an independent association between plasma leptin level and CVD. In male, plasma leptin levels were significantly higher in subjects with macroalbuminuria and coronary heart disease (CHD) than those without macroalbuminuria and CHD, respectively. However, there were no significant differences between other micro- and macrovascular complications in male. In a multivariate analysis, plasma leptin levels were independently associated with macroalbuminuria and CHD. Conclusion This study suggests that plasma leptin levels may be associated with microangiopathy and macroangiopathy in type 2 diabetic patients and there may be sex differences in their relationships. PE22