Background and aim: This study examined factors associated with elevated renal resistive index in patients with type 2 diabetes. RRI, measured using Doppler ultrasound, indicates renal vascular resistance. Increased RRI has been observed in this patient population. Factors linked to higher RRI include older age, female gender, high blood pressure, elevated heart rate, increased body mass index, smoking, dyslipidemia, and certain medical conditions or medications. The aim of this research was to investigate these factors to enhance clinical management of patients with type 2 diabetes. Methods and Material: This was a cross-sectional study conducted at Wahidin Sudirohusodo hospital in Makassar. It included adult patients with type 2 diabetes mellitus who underwent Doppler ultrasonography. An elevated renal resistive index was defined as a value greater than 0.70. The researchers analyzed the renal resistive index values in relation to factors such as age, diabetes duration, blood pressure, heart rate, body mass index, dyslipidemia, medical history, smoking, and concurrent medications. The data were analyzed using logistic regression and chi-square statistical tests. Results: The study found that age, heart rate, dyslipidemia (odd ratio 10.2), and over 10 years of diabetes (odd ratio 8.9) were factors influencing the renal resistive index. Patients with high blood pressure, obesity, beta-blocker use, and heart failure had a higher proportion of elevated renal resistive index. Conclusions: RRI in patients with diabetes mellitus is influencedby heart rate, age, duration of diabetes and dyslipidemia. Dyslipidemia has a 10.2-fold higher risk of increased RRI. Keywords: Renal resistive index, Diabetes mellitus, renal ultrasonography, renal resistive index in diabetic patients, renal resistance