OBJECTIVES: (1) To assess prevalence of diabetic retinopathy in Diabetes Mellitus in Warangal region, (2) To assess the various risk factors in diabetic retinopathy patients, (3) To find out effect of duration of Diabetes Mellitus on severity of Diabetic Retinopathy. METHODS: The study was a Hospital-based, Prospective observational study. Conducted on 452 diabetic male and female volunteers that fulfilled the inclusion criteria, with their proper consent for 6 months. All are underwent detailed ophthalmoscopic examinations for Diabetic Retinopathy, out of which 223 patients developing the Diabetic Retinopathy. The International Clinical Diabetic Retinopathy and Diabetic Macula edema Disease Severity Scale was followed to categorize Retinopathy in different stages. RESULTS:  We observed that overall, prevalence of DR in Diabetic patients of Warangal region was 49.34%. Prevalence of Non-Proliferative DR, Proliferative DR and Macular edema were 31.19%, 10.8% and 7.3% respectively, Statistically significant variables on student t-test, chi square test and Univariate analysis, associated with increased risk of diabetic retinopathy were gender men at greater risk (P<0.0001), longer duration of diabetes15 years (P<0.0001), use of insulin (P< 0.0001), age >60 years of DM (OR 1.83, 95% CI 1.25-2.68), Patient with age group 40-60 years are at greater risk for Macular edema showed a statistically significant (OR 1.18, 95% CI 0.18-2.01), Also Poor FBS are at greater risk (OR 0.34, 95% CI O.15-0.77). CONCLUSIONS: This study concluded that prevalence of DR in DM patients of Warangal region 49.34% and that it increased with age, duration of DM and poor glycemic control and needs early detection and appropriate treatment to prevent blindness due to this condition.