Background: Preventing diabetic foot is a critical issue worldwide. Burger Allen Exercise and reflexology are considered the keystones for improving the lower extremity perfusion, and decreasing pain among diabetic patients. Objective: To determine the effect of Buerger Allen exercise versus Reflexology on lower extremity perfusion and pain among patients with type 2 Diabetes Mellitus. Settings: The study was carried out at Inpatient Medical Department of the National Medical Institute in Damanhur, El-Beheria governorate, Egypt. Subjects: A convenient sample of 60 adult diabetic patients. Tools: Four tools were used for data collection. Tool 1. Socio-Demographic and Clinical Data Sheet. Tool II. Ankle Brachial Index Scale (ABI) to assess the lower extremity perfusion. Tool III. Selected Clinical Features of Peripheral Vascular Disease Observational Checklist to assess the level of peripheral vascular disease (PVD). Tool IV. Pain Assessment Visual Analog Scale (VAS) to assess pain intensity. Results: The majority of the studied patients of the Buerger Allen exercise achieved "normal" level of Ankle Brechial Index (ABI) scale, “normal" level of PVD symptoms, and “mild" level of pain post intervention (73.3%, 90%, 66.7% respectively). 63.3% of the reflexology group patients achieved “normal" Ankle Brechial Index (ABI) scale, 100 % of them achieved “normal" level of PVD symptoms and 76.7 % achieved “no pain" post interventions. Statistical significant difference was found between the overall mean percent improvement of exercise and reflexology groups regarding level of pain (p<0.001*). Conclusion: Both Buerger Allen Exercise, and reflexology are effective in improving lower extremity perfusion among type 2 diabetes mellitus patients. Diabetic patients who performed reflexology intervention experience less pain more than those who performed Buerger Allen exercise. Recommendations: Encourage health care providers to integrate Buerger Allen exercise & reflexology in the care protocols of patients with DM in different health care settings