Background Diabetic peripheral neuropathy (DPN) is a worldwide costly complication of diabetes. Objective To evaluate the relationship between the sonographically measured cross-sectional area (CSA) of the median nerve and nerve conduction study (NCS) in children with type1 diabetes (T1DM) complaining of DPN. Material and methods Forty children with T1DM and 20 age-matched healthy subjects were enrolled in this study. The diabetic children were divided into 2 groups (without and with DPN). All participants underwent NCS and sonographic measurement of CSA for the median nerve in the carpal tunnel. Results The CSA of the median nerve in children with DPN was higher than that in the control subjects yet with no significant difference with that of children without DPN. The increased median nerve CSA in the carpal tunnel was considerably correlated with the median nerve motor latency and duration of diabetes, nevertheless, with no correlation with median nerve motor conduction velocity (MNCV). Conclusion Sonographic measurement of CSA of the median nerve in the carpal tunnel serves as a good discriminator for diabetic children from healthy individuals. Moreover, it has significant positive correlation with duration of disease and the nerve motor latency.