Background: Newly diagnosed type 2 diabetes mellitus (DM) is associated with insulin resistance (IR). This insulin resistance is related to state of chronic inflammation and inflammatory marker such as neutrophil lymphocyte ratio, which can be used as a predictor inflammatory marker for insulin resistance. Objectives: The aim of this study was to evaluate the relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus in New Demitta Hospital patients. Patients and methods: This study is a prospective one that was carried out on thirty (30) populations and sixty (60) patients newly diagnosed type 2 diabetes mellitus attending to Outpatient Clinic and Inpatient Department of Internal Medicine at Al-Azhar University Hospital, Damietta. All were subjected to full history and clinical examination, laboratory tests include, HOMA IR, HbA1c, serum fasting insulin, CBC, Fasting blood sugar, post prandial glucose level, ALT, AST, serum albumin, bilirubin, GGT, creatinine, urea, uric acid, cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, high sensitive C-reactive proteins, ESR, BMI and urine analysis. Results: Our study showed that there was statistically significant increased neutrophil-lymphocyte ratio and serum triglycerides in group newly diagnosed type 2 diabetes mellitus with IR (BI) in comparison with newly diagnosed type 2 diabetes mellitus without IR group (BII) and controlled group (A).The study showed a significant positive correlation of NLR with HOMA-IR and showed the risk predictors of IR including NLR, TG and HbA1c. Conclusion: The results of this study showed that in newly diagnosed type 2 DM with IR having increased NLR which can be considered as early predictor for IR in those patients.