Aim To investigate the possible mechanism of cerebral infarction in type 2 diabetes mellitus （T2DM） through identifying the changes of metabolic products in serum by applying the method of ¹H-nuclear magnetic resonance （¹H-NMR）. Methods Nineteen patients with cerebral infarction complication in T2DM, 25 T2DM patients without cerebral infarction and 29 healthy controls were included in our study. The micromolecular substances of each participant in serum were detected by 1H-NMR. The metabolic profile of each participant was obtained. The partial least square discriminant analysis （PLS-DA） was used to examine the difference of metabolic profile among groups. Results Based on the analysis of score plots of groups, the T2DM patients with cerebral infarction, T2DM patients without cerebral infarction and the group of healthy controls were clearly distinguished by applying PLS-DA. The characteristic metabolic products of patients with cerebral infarction complication in T2DM included very low density lipoprotein （VLDL）, low density lipoprotein （LDL）, glucose, 3-hydroxy butanoic acid, lactate, pyruvic acid, glycoprotein, leucine, valine, prostaglandin D₂, E₂, homocysteine, trimethylamine oxide （TMAO） and betaine. Conclusions The results of our study suggested that the metabolic disorders of lipids, carbohydrate and amino acid may play essential role in the development of T2DM with cerebral infarction. The elevated level of prostaglandin D₂, E₂ and homocysteine might play a role in the occurrence of cerebral infarction in T2DM. The change of TMAO and betaine which were caused by enteric dysbacteriosis, also might be related to the occurrence of cerebral infarction in type 2 diabetes mellitus.