Objective: To investigate the relationships between bone turnover markers and diabetic microvascular complications in type 2 diabetes mellitus. Methods: 146 type 2 diabetes mellitus patients were divided into experimental group (77 patients, complicated with diabetic nephropathy and/or diabetic retinopathy) and control group (69 patients, no diabetic microvascular complications). The general informations of patients in 2 groups were recorded; and the blood biochemical indicators and bone turnover markers of patients were detected. Results: The course of disease of patients in experimental group was remarkably longer than control group (P<0.05); the carboxy-terminal collagen crosslinks (CTX) of patients in experimental group was remarkably higher than control group, the osteocalcin (OC) was remarkably lower (P<0.05). Logistic regression analysis showed that CTX and course of disease were risk factors of type 2 diabetes mellitus with microangiopathy, OC was protective factor. Conclusions: Bone turnover markers CTX and OC are associated with the risk of microvascular complications in patients with type 2 diabetes mellitus, which are expected to be markers for monitoring microangiopathy and bone metabolism in patients with type 2 diabetes mellitus.