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Introduction: The relationship between arthropathy and dipeptidyl peptidase-4 (DPP-4) inhibitors has rarely been investigated in Asian patients with type 2 diabetes mellitus (DM) treated with DPP-4 inhibitors. Materials and Methods: The Longitudinal Health Insurance Database 2000, which contains the claims data of one million beneficiaries of the National Health Insurance program, was used as the data source. A total of 19,729 patients who had received a diagnosis of type 2 DM, had received oral antidiabetic agents for at least 3 months, or were hospitalized with a diagnosis of DM without joint pain between January 1, 2009, and December 31, 2010, were recruited and followed for 1 year. Patients who received sitagliptin for at least 1 month were defined as sitagliptin users. Results: With sitagliptin use, arthralgia occurred early after the initiation of treatment when the cumulative defined daily dose (DDD) of sitagliptin was <84. The risk of joint pain did not increase significantly when sitagliptin was used for 1 year. By contrast, joint pain significantly decreased with sitagliptin use (p < 0.001). Conclusions: The cumulative DDD of nonsteroidal anti-inflammatory drugs did not increase with sitagliptin use; however, it significantly decreased within 1 year after the beginning of sitagliptin use. This may be attributable to the anti-inflammatory effect exerted by sitagliptin. Thus, Dipeptidyl Peptidase-4 Inhibitor use may reduce joint pain in patients with type 2 Diabetes Mellitus.