The high sensitivity C-reactive protein (hsCRP) is known to be a sensitive predictor of coronary heart disease and type 2 diabetes. This study evaluated the association between the serum hsCRP and the components of metabolic syndrome (MS) and microvascular complications in type 2 diabetes. Two hundred and sixty-nine patients with type 2 diabetes were enrolled. All the subjects underwent measurement of MS and carotid intima-media thickness (IMT). The serum hsCRP concentrations and the 24 h urine albumin excretion amounts were measured. Ophthalmoscope examinations and nerve conduction velocity tests were performed to evaluate microvascular complications. The hsCRP was significantly higher in the patients with MS than in those without (p=0.019). The serum hsCRP was significantly correlated with all the components of MS. There were no differences between the serum hsCRP levels of those with and without retinopathy and neuropathy. The serum hsCRP was correlated with the 24 h urine albumin excretion amount. Serum hsCRP level has a significant correlation with MS and might be used as the future criteria of MS. Among microvascular complications, only diabetic nephropathy is associated with the serum hsCRP level. It suggests that the inflammatory process plays a role in nephropathy in type 2 diabetes.