BACKGROUND: Numerous diagnostic methods have been evolved for diabetic peripheral neuropathy (DPN) with differential accuracy. Uncertainty exists regarding their individual estimates i.e. they vary in terms of sensitivity and specificity. Therefore present systematic review is aimed to furnish evidence regarding diagnostic accuracy of different methods in DPN. OBJECTIVES: To evaluate diagnostic accuracy of different assessment methods by considering clinical examination and nerve conduction studies as reference standards. METHODS: Electronic searches in PubMed, Cochrane, Cinahl and Embase were performed to identify relevant studies. Studies were only included if patients were diagnosed by either clinical examination or nerve conduction studies or both and 2x2 table was feasible to acquire diagnostic measures. RESULTS: A total of 27 studies were included in this systematic review. Meta-analysis was performed for Nerve conduction studies (NCS), Neurological examination (NE) studies and skin biopsy studies. The reported pooled estimates of sensitivity and specificity for NCS (0.800 and 0.825), NE (0.911 and 0.910) and skin biopsy (0.805 and 0.609) respectively. The NE studies reported highest youden’s index i.e. 0.821 followed by NCS was 0.625 and skin biopsy was 0.414. CONCLUSIONS: Among three included methods NCS, NE and skin biopsy, the NE method reported highest positive supportive evidence.