Abstract： Objective To estimate the prevalence rate and risk factors of diabetic retinopathy (DR) in rural residents in Shandong. Methods A total of 16 330 residents in 8 counties in Shandong province underwent the screening of diabetes by multi-stage randomized cluster-sampling; while the standard of diagnosis of diabetes was in accordance with the WHO standard (1990). Diabetes was diagnosed in 707 residents who then underwent questionnaire survey and examinations of fasting blood-glucose, urine protein, visual acuity, slit-lamp microscope, and direct opthalmoscope. The standard of DR screening was drawn according to the international DR classification (2002). The data were statistically analyzed with SPSS 11.5 software. Results In 16 330 residents, 707 were with diabetes (4. 33%), 26.30% of them (181 cases) had DR (1.11% of all the residents). Multivariable analysis showed that kidney damage, hypertension and high blood glucose were the risk factors for DR; while the age, sex, and family history were not related much to DR. Conclusion The prevalence rate of DR in rural residents of Shandong is high. Kidney involvement, hypertension and high blood glucose are the risk factors of DR.