: We investigated the relationship between bone metabolic markers or bone mineral density (BMD) and sarcopenia in patients with type 2 diabetes mellitus (T2DM). : In this cross-sectional study involving 119 subjects (76 women and 43 men), bone metabolic markers were evaluated by bone alkaline phosphatase and bone tartrate-resistant acid phosphatase (TRACP-5b). BMD was measured using the dual-energy X-ray absorptiometry method, and sarcopenia was diagnosed using skeletal muscle mass index (SMI), evaluated by body composition measurement and handgrip strength. : Significant correlation was observed between handgrip strength or SMI and TRACP-5b in both sexes (correlation coefficients were -0.50 in handgrip strength and -0.41 in SMI in men; -0.25 in handgrip strength and -0.21 in SMI in women). Furthermore, significant correlation was observed between handgrip strength or SMI and BMD of the femoral neck in both sexes (correlation coefficients were 0.33 in handgrip strength and 0.44 in SMI in men; 0.34 in handgrip strength and 0.47 in SMI in women). The concentrations of TRACP-5b with sarcopenia were significantly higher than those without (643.8 ± 261.9 vs. 455.7 ± 165.6 mU/dL), and BMD of femoral neck with sarcopenia was significantly lower than those without (0.54 ± 0.12 vs. 0.66 ± 0.16 g/cm). TRACP-5b (odds ratio 1.05, 95% confidence interval 1.01-1.10) and femoral neck BMD (odds ratio 0.30, 95% confidence interval 0.14-0.68) were associated with the presence of sarcopenia after adjustment for confounders. : TRACP-5b and BMD of the femoral neck were associated with sarcopenia in patients with T2DM.