Visfatin is a novel adipocytokine, which is suggested to play a role in kidney diseases. We hypothesized that diabetics with diabetic nephropathy may have a different gene profile and this study was performed to evaluate the association between visfatin gene promoter region SNPs and diabetic nephropathy. Realtime PCR was used to study SNPs (1001T/G, 423A/G, 1535C/T) of the visfatin gene promoter region in 30 type 2 diabetics with nephropathy, 30 type 2 diabetics without nephropathy, and 30 healthy volunteers who served as control. Routine biochemical parameters, serum insulin, TNF-α, urinary protein and microalbumine were tested in subjects. Insulin resistance was evaluated by the HOMA method. Non-heterozygotes for the SNPs 423 A/G and 1001 T/G had significantly less risk of having nephropathy (for each group odds ratio 0.181 with 95% confidence interval:0.048-0.674). They also had lower serum visfatin levels than subjects with AA and TT genotypes (P=0.035 and P=0.030, respectively). We could not find any relationship between genotype and gender, BMI, HOMA-IR score, HbA1c, proteinuria, serum lipid and TNF-α levels. The two SNPs, 1001 T/G and 423 A/G were in perfect linkage disequilibrium. We, therefore, suggest that visfatin gene polymorphisms may increase the tendency to diabetic nephropathy