Background: Diabetes mellitus (DM) is a common endocrine disorder worldwide, causing multisystem comorbidities, which compromise organ functions including musculoskeletal complications that affect the quality of life up to handicapping. Ultrasound is a very sensitive tool and a strong predictor of a DM musculoskeletal (MSK) changes, aiding in early management and control of disease parameters preventing subsequent comorbidities. Objective: This study aimed to evaluate if there is a relation between sonographic musculo-tendinous structural changes and diabetes and to correlate them with both clinical and laboratory parameters. Patient and Methods: 40 diabetic patients and 25 healthy subjects were involved in this work. All participants underwent history taking, general and musculoskeletal examination and laboratory and ultrasonographic evaluation. Results: 28 diabetic females and 12 diabetic males with mean age of 49.8± 13.7 years, showed statistically significant tendinous changes mainly tendon thickness compared to controls (p