African Americans experience high rates of type 2 diabetes of mellitus (T2DM). They also tend to live in adverse neighborhood social and physical environments. We examined the impact of these neighborhood features on T2DM in African Americans. Higher neighborhood social cohesion was associated with lower incidence of T2DM. Higher density of unfavorable food stores was associated with higher incidence of T2DM. Improving community ties or attracting healthy food stores may reduce T2DM.