Purpose <p>Chronic inflammation plays an important role in the pathogenesis of type 2 diabetic (T2D) and its associated complications, especially diabetic nephropathy (DN), and diet can moderate systemic inflammation. The aim of the study was to investigate the relationships between Dietary Inflammatory Index (DII) and odds of DN in T2D patients in Iran.</p> Methods <p>In this case-control study, three hundred and nine patients with T2D (158 patients with DN and 151 patients with non-DN) were included in the study based on existing criteria. Diet was assessed using a valid 147-item food frequency questionnaire (FFQ) and DII index including thirty-six nutrients was calculated using FFQ. Finally, odds ratio (ORs) and 95% confidence interval (CIs) were used to examine the relationship.</p> Results <p>The mean ± SD age and BMI of the study participants were 56.21 ± 12.37 years and 27.22 ± 3.82&#xa0;kg/m2, respectively. Compared to controls subjects, DN patients had significantly higher duration of diabetes, level of fasting insulin, and creatinine as well as lower intakes of energy, carbohydrates, mono and poly-unsaturated fatty acids, fiber, cholesterol, some micronutrients and antioxidant vitamins compared to controls. After potential confounders were adjusted, those in the highest quartile of the DII had significantly higher odds of DN than those in the lowest quartile (OR = 2.49, p for trend = 0.028).</p> Conclusion <p>In general, it seems that adopting a healthy diet and lifestyle characterized by lower inflammatory potential, may be an effective approach to reduce the likelihood of DN.</p>