OBJECTIVE: To explore the traditional Chinese medicine (TCM) diagnosis and treatment of type 2 diabetes in Tianjin urban population. METHODS: A cross-sectional study was conducted on hospital patients with type 2 diabetes in TCM hospitals of different levels in Tianjin from 2003 to 2007. The multiphasic stratified cluster sampling method was adopted in selecting the target hospital. Finally 3,496 patients were selected as the survey sample. Then the constituent ratios of diabetes in different syndrome types were calculated. RESULTS: In this study, the descending sort proportion of TCM syndrome types of type 2 diabetes in Tianjin urban population was deficiency of both qi and yin, stagnation of phlegm-dampness, exuberant heat due to yin deficiency, deficiency of both yin and yang, and blood stasis and qi stagnation. Most of the diabetes patients with deficiency of both qi and yin, deficiency of both yin and yang, and stagnation of phlegm-dampness were older than 60 years. Most of the diabetes patients with exuberant heat due to yin deficiency were 50 to 59 years old, while the diabetes patients with blood stasis and qi stagnation were 40 to 49 years old. The frequency of Danggui (Angelica sinensis) use was high in the diabetes patients with deficiency of both qi and yin; the frequency of Chenpi (Citrus reticulate Blanco) use was high in the diabetes patients with exuberant heat due to yin deficiency; the frequency of Baishao (Radix Paeoniae Alba) use was high in the diabetes patients with deficiency of both qi and yin; the frequency of Gancao (Radix Glycyrrhizae) use was high in the diabetes patients with stagnation of phlegm-dampness; and the frequency of Xingren (Semen Armeniacae) use was high in the diabetes patients with blood stasis and qi stagnation. CONCLUSION: The main syndrome types of diabetes patients in Tianjin urban area are deficiency of both qi and yin, stagnation of phlegm-dampness and exuberant heat due to yin deficiency. And the patients are mainly older than 50 years. The most frequently used herbs are Danggui (Angelica sinensis), Chenpi (Citrus reticulate Blanco), Baishao (Radix Paeoniae Alba), Gancao (Radix Glycyrrhizae) and Xingren (Semen Armeniacae).