Objective To compare the MDCT manifestations of lower extremity vascular lesions between diabetic and non-diabetic patients. Methods A total of 60 cases of diabetic and non-diabetic patients with lower extremity vascular lesions from January 2015 to January 2016 were selected, set the diabetic patients with lower extremity vascular lesions as group A and group B patients without diabetic. All patients underwent dual source CT detection. Results There were statistical significance differences in the location of lower extremity vascular lesions between the two groups(P<0.05), the difference of lower extremity vascular stenosis degree between the two groups were statistically significant (P<0.05), the plaque characteristics of B group were mainly non calcified plaques, while the plaque characteristics of A group were mainly calcified plaques. Conclusion The MDCT manifestations of lower extremity vascular lesions caused by diabetes were: the location of the lesion was below the level of the knee joint, and the degree of vascular stenosis was moderate, and the plaques were characterized by calcified plaques. Multi slice spiral CT has clinical value in the differential diagnosis of lower extremities vascular lesions in diabetic and non-diabetic patients.