Background: We aimed to examine the atherosclerotic patterns of lower limb arteries in patients with diabetes mellitus undergoing angiography in Razi hospital, Rasht, Iran, in 2016.Methods: In this retrospective cross-sectional study, patients with diabetes mellitus underwent angiography in an endovascular surgery center in Razi Hospital in Rasht in 2016, were evaluated. Demographic characteristics, disease-related factors, and angiographic findings were recorded. Proximal Pattern in this study was defined as significant involvement of suprageniculate arteries, and the distal pattern was defined as significant involvement of infrageniculate arteries. The extent of vascular involvement in this study was measured by trans-atlantic inter-society consensus 2 (TASC2) scale.Findings: 169 patients were included in this study. 60.9% of the patients were men, and the average age was 64.34 ± 10.26 years. Chief complaint in 58% of the patients was non-healing ulcer (58.0%). 47.3% of the patients had dyslipidemia, 65.1% had hypertension, and 22.5% of them had no other underlying diseases. 24.3% of the patients were smokers. In general, in 62.7% of all patients, the pattern of atherosclerotic involvement was distal. There was no significant relation between atherosclerotic involvement pattern and sex, body mass index (BMI) range, history of renal disease, or dyslipidemia.Conclusion: The findings showed that the most prevalent pattern of atherosclerotic vascular involvement in patients with diabetes mellitus was distal pattern. There was no significant relationship between atherosclerotic pattern and sex, BMI, history of renal disease, and dyslipidemia.