Objective: To analyze the correlation between lower extremity atherosclerosis grading and cardiovascular and cerebrovascular diseases in patients with type 2 diabetes, and to explore the risk factors of lower extremity arterial plaque formation in type 2 diabetes. Methods: A total of 2 824 patients with type 2 diabetes mellitus who were hospitalized in Hefei First People’s Hospital from January 2010 to December 2016 were enrolled. The patients were divided into the cerebral infarction group and the non-cerebral infarction group, including the coronary heart disease group and the non-coronary heart disease group. According to the results of color Doppler ultrasound of lower extremity arteries, the degree of arteriosclerosis was graded. Logistic regression was used to analyze the correlation between lower extremity atherosclerosis grading and cerebral infarction and coronary heart disease. Results: Patients with grade 3 (OR=2.423) and grade 4 (OR=2.661) had a higher risk of cerebral infarction than grade 3 (OR=1.174) and grade 4 (OR=2.120). The risk of developing coronary heart disease is also high in patients. Formation and age of lower extremity arterial plaque in type 2 diabetes (OR=1.089, P<0.001), systolic blood pressure (OR=1.008, P=0.001), serum creatinine (OR=1.007, P<0.001), low-density lipoprotein cholesterol (OR=1.157, P=0.003) related. Conclusion: The higher the classification of lower extremity atherosclerosis in patients with type 2 diabetes, the greater the risk of cerebral infarction and coronary heart disease. Early clinical intervention on the formation of lower extremity arterial plaque is beneficial to prevent cardiovascular and cerebrovascular diseases.