The incidence and risk factors of Diabetic Retinopathy (DR) among type 2 diabetic subjects has been discussed in this book. A random sample of 977 diabetic patients was recruited in 2008 from amongst those who were first diagnosed as diabetic patient in 1993 at BIRDEM hospital in Bangladesh. The incidence rates of DR (95% CI) were 23.54 (19.61-28.26), 17.52 (14.93-20.55) and 21.47 (18.86-24.44) per 1000 person-years at 5, 10 and 15 years of follow-up respectively. Patients with retinopathy had poor glycemic control during three different time periods than patients without retinopathy (HbA1c 9.6±2.6vs7.7±2.3%, 9.9±2.1vs8.0±2.3% and 10.38±2.1vs7.27±1.5%, respectively; P>0.05). It was noted that age, area of residence, occupation, total cholesterol, triglycerides, serum creatinine level and hypertension were found to be independent risk factors for the development of retinopathy. Duration of Diabetes Mellitus and glycemic control seems to be the most important determinants of DR in this population. Tight glucose controls to avoid complication are warranted, for which improved coordination between physician and ophthalmologist are needed along with necessary policy developments.