Diabetic neuropathy (DN) is a debilitating complication of diabetes characterized by progressive nerve damage and associated muscular atrophy. Despite its prevalence, the microstructural changes in peripheral nerves and musculature remain poorly understood. Advanced 3D imaging techniques provide an opportunity for detailed anatomical visualization. Objective: To investigate the microstructural alterations in peripheral nerves and associated musculature in patients with diabetic neuropathy using advanced 3D imaging. Methodology: This cross-sectional study was conducted at Lahore General Hospital during June 2023 to June 2024.Data were collected from 110 patients. Data were collected through a designed questionnaire which included all basic information, demographic and clinical data. Before imaging, all participants underwent a thorough clinical examination to evaluate the severity of diabetic neuropathy. Results: The study included 110 participants with a mean age of 58.4 ± 8.5 years, with a slight male predominance (54.5%). The average duration of diabetes among participants was 12.5 ± 4.2 years. Neuropathy severity was classified into three groups: mild (36.4%), moderate (36.4%), and severe (27.2%), as assessed using the Neuropathy Disability Score (NDS). This distribution reflects the diverse range of neuropathy severities within the sample. Conclusion: It is concluded that advanced 3D imaging techniques, such as MRI and Diffusion Tensor Imaging (DTI), offer valuable insights into the anatomical and microstructural alterations in both peripheral nerves and associated musculature in diabetic neuropathy