A common and crippling side effect of diabetes is diabetic neuropathy (DN), which damages nerves and is defined by pain, tingling, and numbness. Antioxidants may be helpful to treat diabetic neuropathy since the disease’s pathophysiology includes significant elements related to oxidative stress and mitochondrial abnormalities. Co-enzyme Q10 (CoQ10), a potent antioxidant and crucial component of the chain of electron transport in the mitochondria, has garnered attention for its potential to save diabetic patients’ nerves from harm. The mechanisms by which CoQ10 protects against diabetic neuropathy are examined in this chapter, with particular attention paid to the compound’s capacity to lower oxidative stress, enhance mitochondrial performance, and regulate inflammatory pathways. Additionally, a review of clinical data is carried out, with a focus on studies that assess the safety and efficacy of CoQ10 treatment in lowering the symptoms of diabetic neuropathy. Even while early trials had positive results, problems including CoQ10’s bioavailability and the necessity for carefully planned, larger-scale research remain. The discussion of potential directions for future study addresses these problems. The chapter aims to proposed a comprehensive of CoQ10’s potential as a medication in the therapy of DN in order to further the compound’s clinical application.