Objective: Anemia is associated with various poor clinical outcomes in chronic kidney disease patients. The aim of present study was to investigate the anemia which affected the degree of dialysis initiation and the initiation time of dialysis in type 2 diabetic nephropathy patients. Methods: This observational, retrospective study included 130 type 2 diabetic nephropathy patients, in Korea. The existence of anemia, the degree of dialysis initiation and the initiation time were reviewed. The clinical characteristics and variables were also compared. Results: The levels of hemoglobin and serum creatinine were significantly correlated with the dialysis initiation (P value < 0.05). During the 10-year follow-up period, the patients with anemia showed rapid decline of renal function and caused more dialysis initiation (54.1 vs. 5.4%, P value < 0.05) compare to the patients without anemia. There was a significant difference in average time to initiate dialysis (45.1 months [8.0~115.8] in patients with anemia vs. 68.3 months [23.3~108.8] in patients without anemia, P value < 0.01). The risk to the dialysis initiation was significantly increased in patients with anemia compared to the patients without anemia (adjusted hazard ratio: 8.1, [95% confidence interval: 2.4~27.0], P value < 0.05). Conclusion: Anemia is associated with rapid decline of renal dysfunction and the faster initiation of dialysis in diabetic nephropathy patients. Therefore, clinicians should have an earlier special attention to anemia during the management of diabetes.