Foot problems are the most common cause of hospital admission in patients with type II diabetes mellitus (DM). Poor muscle perfusion of lower extremities is thought to be the major component in the pathogenesis of foot problems. We used a well-established and non-invasive radionuclide method to objectively evaluate the anterior tibial muscle perfusion of 120 type II DM patients without symptoms/signs of peripheral vascular disease (PVD) in the lower extremities. The patients were separated into groups according to the duration of the disease and condition of blood sugar control. Meanwhile, 60 normal control males with a matched age distribution were also included for comparison. The muscle perfusion were of significant difference between (1) 120 type II DM patients and 60 normal controls, (2) 72 patients with good sugar control and 48 patients with poor sugar control, as well as (3) 64 patients with short disease duration and 56 patient with long disease duration. Based on the objective radionuclide method, we concluded that the muscle perfusion in the lower extremities of type II DM patients without symptoms/signs of PVD is significantly decreased and related to the duration of the disease and condition of blood sugar control.