BackgroundChina has the largest population of diabetic patients worldwide. A diverse population and regional discrepancy in access to health care and diabetes management may lead to unique risk factors for diabetic retinopathy (DR) in different regions of China. This study aimed to evaluate the prevalence and risk factors of DR in rural patients with type 2 diabetes.MethodsThis hospital-based cross-sectional study recruited a sample of 704 type 2 diabetic patients from rural areas referred to Beijing Huairou Hospital, China, from June 1, 2022, to June 1, 2023. The medical history, demographic information, and results of laboratory examinations of patients were collected and analyzed. The diagnosis of DR were performed by experienced ophthalmologists using mydriatic fundus photography.ResultsOut of all patients, 53.8% were male and 46.2% were female. The mean age of patients and duration of diabetes were 54.9 ± 13.0 and 6.2 ± 4.5 years, respectively. The DR prevalence was 16.8%. The independent risk factors for DR in multivariate analysis were diabetes duration > 10 years (OR = 9.16, 95%CI = 5.49–15.30), fasting plasma glucose ≥ 7.2 mmol/L (OR = 3.25, 95%CI = 1.42–7.42), glycosylated hemoglobin ≥ 7% (OR = 6.49, 95%CI = 2.59–16.23), hypertension (OR = 1.59, 95%CI = 1.05–2.40), hyperlipidemia (OR = 2.16, 95%CI = 1.30–3.59), diabetic nephropathy (OR = 1.95, 95%CI = 1.17–3.23), high uric acid level (OR = 3.57, 95%CI = 1.56–8.15), high albumin to creatinine ratio (OR = 2.48, 95%CI = 1.06–5.82), and insulin treatment (OR = 1.79, 95%CI = 1.12–2.88).ConclusionsThis study evaluated the DR prevalence and its associated risk factors among type 2 diabetic patients from rural areas in Beijing’s Huairou District, China. Paying attention to these risk factors may be useful in screening high-risk diabetic patients for DR and adopting early preventive and therapeutic interventions.