Abstract： The purpose of this study was to investigate the relationship between serum insulin level and peripheral vascular disease in patients with diabetic foot. The study found that the levels of fasting blood glucose (FBG) , fasting insulin (FIns) , neutrophil-to-lymphocyte ratio (NLR) , and insulin resistance (HOMA-IR) were higher in hyperinsulinemic patients than those in the non-hyperinsulinemic patients. Pearson correlation analysis showed that NLR was positively correlated with HOMA-IR ( r=0.430, P<0.05) . Logistic regression analysis showed that FBG, FIns, NLR, and HOMA-IR were all risk factors for peripheral vascular disease in patients with diabetic foot. In conclusion, hyperinsulinemia is associated with peripheral vascular disease in patients with type 2 diabetic foot.