Background: Peripheral arterial disease (PAD) is a complication of type 2 diabetes mellitus (T2DM). No systematic review and meta-analysis has been conducted regarding the risk factors of PAD in T2DM populations. Aim: To analyze the pooled effect estimates of risk factors of PAD in T2DM populations. Methods: A systematic literature search was conducted in PubMed/MEDLINE, ProQuest, and EMBASE databases. The Newcastle-Ottawa Scale was used to assess the risk of bias. Meta-analysis was performed using RevMan version 5.4. Results: Ten studies were included in this review (73,834 samples in total). All the studies had a low risk of bias. Significant association with PAD in T2DM was found in the group of age ≥ 70 years old (OR 3.44; 95 % CI 2.11, 5.62), diabetes duration ≥ 5 years (OR 1.81; 95 % CI 1.24, 2.64), coronary artery disease (CAD) history (OR 1.55; 95 % CI 1.30, 1.83), hypertension (OR 1.43; 95 % CI 1.10, 1.86), and increased LDL (OR 2.51; 95 % CI 1.38, 4.56). Conclusion: Age ≥ 70 years old, diabetes duration ≥ 5 years, CAD history, hypertension, and increased LDL are significant risk factors for PAD in the T2DM population. © 2025 Elsevier B.V.