Background: Diabetic peripheral neuropathy (DPN) is the major microvascular complication of type 2 diabetes mellitus (T2DM). Adropin is a peptide hormone has essential roles in metabolic homeostasis, the pathogenesis of T2DM and its complications. This study was designed to estimate serum adropin levels in T2DM in correlation with risk factors of DPN. We also aimed to investigate the association of serum adropin level with clinical and electrophysiological tests of DPN Methods: This case-control study enrolled 100 patients with T2DM (40 diabetic cases without DPN & 60 diabetic cases with DPN( and 50 controls. All participants were subjected to a complete neurological examination. The motor and sensory conduction of the median nerve, ulnar nerve, common peroneal nerve and were measured. The severity of DPN was assessed by Toronto clinical scoring system (TCSS). Serum adropin levels were assessed using an enzyme-linked immunosorbent assay (ELISA). Results: Our results revealed decreased circulating serum adropin levels in patients with T2DM (3.5± 1.2) especially diabetic patients with DPN (3.1±1.07) compared to controls (6.1± 0.89). There is a negative correlation between serum adropin level and TCSS as well as electrophysiological tests; motor nerve conduction velocity (MNCV) of median and ulnar nerve, sensory nerve conduction velocity (SNCV) of median and ulnar nerve), compound muscle action potential (CMAP) amplitude (median and ulnar nerve) and sensory nerve action potential (SNAP ) amplitude (median, ulnar and PT nerve) ,P ˂0.001* . Conclusion: Diabetic patients with DPN had lower values of serum adropin than diabetic patients without DPN. and serum adropin levels were negatively correlated with metabolic risk factors, TCSS as well as electrophysiological tests of DPN.