Abstract: Objective　To investigate the association between neutrophil to lymphocyte ratio (NLR) and renal tubular injury in type 2 diabetes mellitus patients (T2DM). Methods　A total of 258 patients with T2DM were selected in this study. Data of the general data, the absolute values of neutrophils and lymphocytes were collected. The NLR was calculated. The 24 h urinary microalbumin (24 h UMA) and renal tubular markers β2-microglobulin (β2-MG), β-galactosidase (GAL), and retinol-binding protein (RBP), N-acetyl-β-D-glucosidase (NAG) were detected by immunity transmission turbidity. The renal tubular function was considered as the normal if the above four markers were normal. If any one or more markers exceed the upper limit, it was regarded as renal tubular injury. The patients were divided into the normal group (n=142) and the injury group (n=116)  according to whether the renal tubular function was impaired. The difference of NLR levels was compared between the two groups. According to the presence of any one, two and three types of renal tubular marker abnormalities, the patients in the injury group were divided into subgroups, and the differences of NLR levels were compared between the subgroups. In addition, the correlation between NLR and β2-MG, GAL, RBP and NAG was analyzed. Binary Logistic regression was used to analyze the influencing factors of renal tubular injury in patients with T2DM. Results　The level of NLR was significantly higher in the injury group than that of the normal group (P＜0.05). The level of NLR increased gradually with the increase of abnormal types of renal tubular markers and the aggravation of the renal tubular damage (P＜0.05). NLR was positively correlated with β2-MG, GAL, RBP and 24 h UMA (r =0.191, 0.152, 0.131 and 0.158, P＜0.05). Logistic regression analysis showed that the higher levels of NLR and 24 h UMA were risk factors for renal tubular injury in patients with T2DM, and the higher level of HDL-C was its protective factor. Conclusion　NLR is closely related to renal tubular injury in patients with T2DM, and which can reflect the degree of renal tubular damage.