Diabetic neuropathy is one of the most common and debilitating complications of diabetes, affecting nearly half of all individuals with longstanding disease. It is characterized by progressive nerve damage caused by chronic hyperglycemia, oxidative stress, and microvascular injury. The most prevalent form is distal symmetric polyneuropathy, which presents with numbness, tingling, pain, and sensory loss in the lower extremities. Other forms include autonomic neuropathy, affecting cardiovascular, gastrointestinal, and genitourinary systems, and focal mononeuropathies. The pathogenesis involves complex metabolic and vascular mechanisms, including advanced glycation end-products (AGEs), mitochondrial dysfunction, and impaired neurotrophic support. Early diagnosis relies on clinical examination, symptom scoring systems, and electrophysiological studies. Management focuses on optimal glycemic control, symptom relief, and prevention of complications such as foot ulcers and amputations. Medications like pregabalin, duloxetine, and tricyclic antidepressants are used for neuropathic pain. Multidisciplinary foot care and patient education are critical components of prevention. Ongoing research aims to develop disease-modifying therapies targeting the underlying mechanisms of nerve damage in diabetes.