Background <p>The estimated glucose disposal rate (eGDR) is a novel surrogate for insulin resistance (IR). While it has shown potential in cardiovascular and metabolic outcomes, its relationship with hyperuricemia remains unclear. Therefore, this study aims to explore the association between eGDR and hyperuricemia in patients with type 2 diabetes mellitus (T2DM).</p> Methods <p>A total of 1,238 patients with T2DM were included in this cross-sectional study. eGDR was calculated using waist circumference, hypertension diagnosis, and HbA1c values measured at baseline. Logistic regression models were used to evaluate the association between eGDR and hyperuricemia. Stratified and interaction analyses were performed to confirm the reliability of the results.</p> Results <p>The prevalence of hyperuricemia was 29.7% in our study. After adjusting for potential confounders, each standard deviation (SD) increase in eGDR was associated with 17% lower odds of hyperuricemia (OR = 0.83, 95% CI: 0.72–0.95, <i>P</i> &lt; 0.001). This significant negative association between eGDR and hyperuricemia remained consistent when eGDR was analyzed in tertiles. Subgroup analyses showed that lower eGDR levels were associated with higher odds of hyperuricemia across all subgroups, with no significant interaction effects.</p> Conclusions <p>eGDR was inversely associated with hyperuricemia in Chinese patients with type 2 diabetes mellitus.</p>