Objective: Hypertension and type 2 diabetes mellitus (T2DM) have been shown to have a correlation with bone mineral density (BMD), but the relationship between blood pressure and BMD in middle-aged and elderly men with T2DM There is little research. This study aims to study the effects of different blood pressure levels on BMD in middle-aged and elderly men with T2DM, and to analyze other factors that may affect BMD in this part of the population. Methods: We enrolled 99 middle-aged and elderly men with T2DM, collected relevant medical history, drug history, and lifestyle habits, and performed general data measurement, laboratory tests, and BMD determinations on the subjects. Results: There was no statistically significant difference in general data, living habits and laboratory test results among subjects with different blood pressure. Analysis shows that middle-aged and elderly men with T2DM and moderately hypertensive BMD have lower bone density than normal blood pressure subjects. We grouped and evaluated blood pressure levels and found that BMD and blood pressure levels did not show a linear relationship, but showed different correlations between different blood pressure gradients. Smoking increases the risk of lumbar osteopenia. There is a certain correlation between blood lipids and bone density, which may be an influencing factor for osteoporosis. Conclusion: For middle-aged and elderly men with T2DM, controlling blood pressure at a lower level is more conducive to bone health.