Objective This study was performed to assess the patient-level economic burden of diabetic peripheral neuropathy (DPN) through a cross-sectional survey including 4,000 patients with type 2 diabetes mellitus in Korea. Methods A nation-wide, multi-center study was performed to estimate healthcare and non-healthcare cost, and productivity loss for recent 3 months in the patients with type 2 diabetes mellitus with and without DPN. DPN was defined as physician-diagnosed DPN or MNSI score over 2 points with abnormal monofilament test. Economic burden according to the presence of pain in DPN patients was also analyzed. Results Mean age of study population was 60.94 ± 11.9 years and 33.5% (n = 1,338) of them had DPN. Monthly average number of visit to out-patient clinic was higher in the patients with DPN than those in the patients without DPN (1.26 ± 1.01 vs 1.04 ± 0.81, P < 0.0001). Total costs from health care, non-healcare and productivity loss were significantly higher in the patients with DPN than those in the patients without DPN (554,426 KRW vs 362,357 KRW, P < 0.0001). All parameters in productivity loss like away from work, days accoomplished less at work, and days missed work were were significantly worse in the patients with DPN compared with those in the patients without DPN. Total costs from health care, non-healcare and productivity loss were significantly higher in the DPN patients with pain (DPNP) than those in the DPN patients without pain (687,422 KRW vs 461,312 KRW, P = 0.0034). All parameters in productivity loss like away from work, days accoomplished less at work, and days missed work were were significantly worse in the patients with DPNP compared with those in the DPN patients without pain (non-DPNP). Conclusion Our results suggest that the patient-level burden among DPN sufferers in Korea is significant, evidenced by health resource use and work/activity limitations. DPN was associated with greater healthcare cost and decreased work-productivity in Korean patients with diabetes. When combined with pain in DPN patient, economic burden from healthcare cost and productivity loss further increased compared with those of non-DPNP.