Objective To investigate the changes of serum leptin (LPN) and neuropeptide Y (NPY) in patients with type 2 diabetes and different grades of hypertension and its clinical value. Methods In this study, 197 patients with type 2 diabetes were selected and divided into 45 cases of simple diabetes (DS group) and 152 cases of type 2 diabetes with different grades of hypertension (DH group). The DH group included 47 cases of diabetic patients with grade 1 hypertension (DH1 group), 51 cases of diabetic patients with grade 2 hypertension (DH2 group) and 54 cases of diabetic patients with grade 3 hypertension (DH3 group). Meanwhile 40 healthy people were enrolled in this study as normal controls (NS group). The serum levels of LPN and NPY were detected by ELISA. The relationships of LPN and NPY with each influencing factor were analyzed by multiple linear regression. Results The levels of LPN and NPY in the DS group were higher than those in the NS group, at the same time, the levels of LPN and NPY in the DH1 and DH2 and DH3 groups were higher than those in the DS group, and were the highest in the DH3 group (P < 0.05). The result of the related analysis showed that LPN and NPY were positively correlated with SBP and FBG. Logistic regression analysis showed that SBP and FBG both were positively correlated with LPN and NPY levels. Conclusions Serum levels of LPN and NPY increase in patients with type 2 diabetes and hypertension. Both LPN and NPY might be closely related to the occurrence and development of diabetes and hypertension.