Abstract: Objective To discuss the clinical significance and diagnosis value of color Doppler ultrasound for lower limbs angiopathy in elderly patients with T2DM. Methods Total 450 elderly patients with T2DM were enrolled into observation group and 200 healthy volunteers into the control group in our hospital between June 2010 and May 2013.The color Doppler ultrasound was performed to estimate the angiopathy of lower Limbs. The data was analyzed and compared between the two groups by using SPSS 13.0. Results The rate of atherosclerotic plaque formation in the observation group was 95.6% (430/450), significantly higher than 26.5%(53/200) in the control group (χ²=345.85,P<0.01); The detection rate of lower limb vascular lesion was 12.8%(22/172) in the patients with T2DM with a duration less than 10 years,61.7%(116/188) in the patients with a duration of 10-20 years(χ²=90.90,P＜0.01), and 100.0%(90/90) in the patients with a duration over 20 years (χ²=46.52,P＜0.01);The difference was statistical significant.The inner diameter of the lower limb vascular in T2DM patients become stenosis, when compared with the control group,the inner diameters of the lower limb arteries (common femoral artery, superficial femoral artery, deep femoral artery, popliteal artery, posterior tibial artery, dorsal pedal artery) in T2DM patients with a duration of 15 years or more were thinner (t=94.64，173.46，103.49，176.33，122.84，103.65，P＜0.01), respectively;the stenosis of dorsal pedal artery in the observation group was significantly serious than that in the control group(χ²=349.93，88.71，13.85，41.12，16.94，P<0.01, respectively). Conclusion The color Doppler ultrasound for the diagnosis of lower limb vascular angiopathy in elderly patients with T2DM is receptive, with the advantages of high accuracy and safety, easy to operate, high repeatability and noninvasive evaluation. It can provide certain clinical guiding for the treatment of the disease.