Abstract： Objective To estimate the prevalence rate and risk factors of diabetic retinopathy (DR) in rural residents in Changzhi. Methods With the help of an established resident health data, a epidemiology study was performed on 63 409 residents (≥15 years old) in the rural area of Changzhi; while the standard of diagnosis of diabetes was in accordance with the standard made by WHO in 1997. Diabetes was diagnosed in 2632 residents, and these patients underwent the investigation and examination including the disease history, glycosylated hemoglobin (HbAlc), fasting blood glucose, visual acuity, ocular diseases and intraocular pressure. The standard of DR was drawn according to the diagnosis standard made by Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association in 1985. The data was statistically analyzed by SPSS 13.0 software. Results A total of 57 500 residents underwent the examination with the participating rate of 90.68% ; 2632(4. 58%) were diagnosed as with diabetes, in whom 986 were with DR (with DR prevalence of 37.46%). The duration of diabetes was the independent risk factor of DR (r=0. 210,P<0. 001). The duration of diabetes and combined with hypertension were the influence factors of the development of DR. The visual acuity in residents with or without DR differed significantly(P<0.01). The level of HbA1c was positively related to DR. Conclusions The incidence of DR is high in residents with diabetes in eastern countryside area of Changzhi. The duration of diabetes and combined with hypertension were the influence factors of the development of DR. The level of HbAlc may be the important indicator which can monitor the occurrence and development of DR in patients with diabetes.