Objective To analyze the distribution and clinical characteristics of TCM syndromes in patients with type 1 diabetes. Methods Totally 169 patients with type 1 diabetes at Department of endocrinology, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine were recruited from January 2012 to December 2019. The distribution of TCM syndrome types of patients and the clinical characteristics of different TCM syndromes were observed. Results 169 patients with type 1 diabetes had the most syndrome of deficiency of both qi and yin (88.76%), followed by deficiency of yin and yang syndrome(10.06%), and the lowest proportion of deficiency of yin and yang(1.18%). The distribution of blood stasis syndrome is the most, followed by phlegm-dampness syndrome. There were no significant differences in age, BMI, course , FBG, PBG, HbA1c and acute complications between the main and concurrent syndrome types of T1D(P>0.05). In terms of chronic complications, the incidence of diabetic nephropathy with Yin deficiency and fire vigour syndrome was significantly higher than that of the other groups(P<0.05). There were no significant differences in the incidence of the other groups of DPN, DR, atherosclerosis, coronary heart disease, and cerebral infarction(P>0.05). Conclusion Deficiency of both Qi and Yin is the main syndrome of type 1 diabetes. Diabetic nephropathy is more likely to occur in type 1 diabetes with Yin deficiency and fire flourishing syndrome.