Background: Type 2 diabetes mellitus is the most common form of diabetes. Millions of patients worldwide have been diagnosed as type 2 diabetes and many more are unaware they are at high risk. It represents a major public health threat and constitutes an important contributor to the predicted decline in life expectancy. Objective: The aim of the present work was to evaluate serum chemerin level and its association with kidney functions in patients with type 2 diabetes mellitus. Patients and methods: This case control study was conducted at Clinical Pathology Departments of Al-Azhar University Hospitals. It was carried out on 80 subjects of matched age and sex divided as 60 type 2 diabetic patients and 20 apparently healthy volunteers (hospital staff) serving as control group. Results: In a correlation study between serum chemerin and other studied parameter in diabetic patients, a significant positive correlation was found between serum levels of chemerin, FBS, ACR, serum creatinine, serum urea, fasting insulin, HOMA-IR index and BMI. On the other hand, a highly significant negative correlation between serum chemerin and eGFR was observed in patients' group. Furthermore, we evaluated the diagnostic performance of chemerin for discriminating patients with macroalbuminuria from those without. The best diagnostic cutoff for chemerin was 100.1 ng/mL. This had a diagnostic sensitivity of 85%, specificity 75%, negative predictive value 63%, positive predictive value 90.9%. The area under the curve (AUC) was 78.3%. Conclusion: These findings suggested that serum chemerin can be used as a predictive marker for diabetic nephropathy.