Objective To explore the changes of urine albumin-creatinine ratio ( ACR) and urina-ry podocalyxin (PCX) and the relationship of score of Montreal cognitive assessment (MoCA) with urine ACR and PCX in patients with type 2 diabetic mild cognitive impairment. Methods Sixty patients with type 2 diabetes mellitus were used as the control group, and 60 patients with type 2 diabetic mild cognitive impairment as the mild cognitive impairment ( MCI) group. The sex, age, and course of disease and years of education of patients were recorded, the fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), sys-tolic blood pressure ( SBP) , diastolic blood pressure ( DBP) , triglyceride ( TG) , total cholesterol ( TC) , low density lipoprotein ( LDL) , high-density lipoprotein ( HDL) , and urine ACR and PCX were measured, and the score of MoCA was assessed. Results The patients with type 2 diabetic nephropathy in the MCI group were significantly more than the control group (χ2 =73. 818,P<0. 01). The score of MoCA of the MCI group was significantly lower than the control group (P<0. 01), while urine ACR and PCX were high-er than the control group (P<0. 01). The score of MoCA was inversely associated with the urine ACR (r=-0. 868,P<0. 01) and PCX (r= -0. 785,P<0. 01), and those were the independent risk factors for the score of MoCA ( P<0. 01 ) . Conclusions The urine ACR and PCX were closely related to the cognitive function of type 2 diabetes mellitus, which can be used as the screening indexes of type 2 diabetic mild cog-nitive impairment.