Background: The relationship of platelet volume indices including mean platelet volume (MPV) and platelet distribution width (PDW) with carotid intima-media thickness (IMT) as well as vibration perception threshold (VPT) was investigated in type 2 diabetic patients. Methods: A total of 500 type 2 diabetic patients (298 male, 202 female) were enrolled. Clinical and laboratory data were collected from hospital records. Results: Both MPV and PDW were significantly associated with carotid IMT, after adjustment for confounding factors including age, systolic blood pressure, total cholesterol and creatinine (0.833 +/- 0.029 mm vs 0.955 +/- 0.030 mm; 0.839 +/- 0.029 mm vs 0.955 +/- 0.030 mm; P = 0.0015 and P = 0.022, respectively). Agreed with carotid IMT analysis results, significant association was found between PDW and VPT as tertiles (15.760 +/- 1.091V vs 20.187 +/- 1.094V, P = 0.016). In multivariable analysis, both MPV and PDW were significantly associated with VPT (P = 0.021 and P = 0.007, respectively). However, only PDW, but not MPV, was significantly associated with carotid IMT (P = 0.002). Conclusions: These findings implied the predictive value of platelets volume indices in vascular and peripheral neuropathy complications in type 2 diabetes.