Diabetic vasculopathy is one of the major causes of death in patients with diabetes, which has complicate pathogenesis and is not yet clear. Studies showed that biological effects, such as polyol pathway, non-enzymatic glycation of proteins, hexosamine pathway, activation of protein kinase C, oxidative stress, and compensatory system, contribute to the occurrence and development of diabetic vasculopathy. The research progress of risk factors, pathophysiology, and molecular mechanism of occurrence of complications of macroangiopathy in diabetes is reviewed in this paper.