Abstract: Objective To investigate angiographical characteristics of carotid, vertebral, subclavian, and renal arteries in the type 2 diabetic patients with lower extremities peripheral arterial disease (LEPAD). Methods There were 104 type 2 diabetic patients with LEPAD recruited in this study, who received digital subtract arteriography (DSA). Ankle-brachial index (ABI) assessment was also performed in 50 participants. Dependent upon the stenosis degree of vertebral artery, subclavian artery and renal artery measured by DSA, the patients were divided into normal group(stenosis ≤ 50%) or pathological group(stenosis >50% or blocked lesions). The angiographic features of carotid, vertebral, subclavian, and renal arteries were analyzed and the relationship between arterial stenosis and ABI was explored. Results DSA results of 104 patients showed that the most common lesion in the arteries was plaque. The stenosis degrees of 51%-74% and 75%-99% were most commonly observed in renal artery, with incidence of 22.1% and 5.8%, respectively. Arterial occlusion was most commonly observed in vertebral artery, with incidence of 27.9%. The patients with stenosis or occlusion of arteries had lower ABI (P=0.000), and the patients with stenosis or occlusion of vertebral and renal arteries also had lower ABI (P=0.003 and 0.02, respectively), compared with those without stenosis. ABI<0.9 indicated higher risk of stenosis or occlusion of vertebral and renal arteries (P=0.008 and 0.047 respectively). Between the patients with subclavian arterial stenosis and those without this artery stenosis, there was no statistical significant difference observed in ABI level. Conclusion Type 2 diabetic patients with LEPAD can affect multiple arteries, showing plaque formation, multi-segmental stenosis and occlusion of arteries. The patients with ABI<0.9 have higher risk of multiple arterial stenosis or occlusion lesions.