Stroke is the leading-cause of death in women and motor-disability in adults. In patients with diabetes, diabetic peripheral neuropathy (DPN) increases the risk of ischemic stroke. The aim of this work was to test the hypothesis that an etiological pattern of ischemic stroke in patients with DPN can be recognized. This was a single-center retrospective observational study of patients hospitalized in Cayenne general-hospital with ischemic stroke. The primary endpoint was to determine if there is an association between the mechanism of stroke and the presence of DPN. We included 226 patients: mean age 64.14 ± 15.2 years; male predominance (62.4 %); and 5.8 % with DPN, i.e., 14.9 % of patients with diabetes. DPN was significantly associated with small-vessel disease (SVD): adjusted odds ratio=5.08 [1.17;22.14]. These findings highlight a common pathophysiology between DPN and SVD. DPN can provide a window of opportunity to detect SVD and prevent its complications like stroke or dementia.