Background <p>Type 2 diabetic patients tend to have elevated serum fibrinogen concentrations.</p> Objective <p>We conducted this study to evaluate the relationship between serum fibrinogen levels, microvascular complications, and various demographic and clinical characteristics.</p> Methods <p>This prospective case–control study involved 67 diabetic patients who had microvascular complications (cases) compared with 77 type 2 diabetic patients who did not have any microvascular complications (control) admitted or visited the hospital between 2018 and 2020. The patient-related data, including demographics, laboratory investigations, and examination of microvascular complications, were collected. All statistical analyses were conducted using SPSS version 21.</p> Results <p>Most of our patients were in the age group of 40–60&#xa0;years, followed by patients above 60&#xa0;years and less than 40&#xa0;years in both cases and controls. The mean serum fibrinogen levels among case and control were found to be 498.24 ± 129.22 and 351.75 ± 108.01, respectively. The cases exhibited a statistically significant difference in fibrinogen level compared to controls (<i>p-value</i> 0.01). There was a statistically significant difference (<i>p-value</i> 0.007) in mean fibrinogen levels when comparing individuals with both nephropathy and neuropathy with those without any complications. Additionally, fibrinogen levels were significantly associated with body mass index (BMI), total cholesterol (TC), low-density lipoprotein (LDL), and the use of oral hypoglycemic agents and insulin (<i>p-value</i> &lt; 0.05).</p> Conclusion <p>Our study directly correlated fibrinogen levels and microvascular complications. A significant association was found between the BMI, TC, and LDL. Serum fibrinogen can be a valuable biomarker for predicting microvascular complications, thereby preventing its development and progression and facilitating better patient care.</p>