To evaluate the outcomes of aflibercept based on different morphologic patterns on optical coherence tomography (OCT) for diabetic macular edema (DME). Observational study. Beyoglu Eye Training and Research Hospital, Turkey from February 2016 to March 2018. Records of 115 eyes of 115 patients who were treated with aflibercept for DME were reviewed. Eyes were classified based on OCT features as diffuse retinal thickening (DRT, n=37), cystoid macular edema (CME, n=40), and serous retinal detachment (SRD, n=38). Best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) at baseline and after three doses of aflibercept at months 3, 6, 12 were recorded. Primary outcome measures were the changes in BCVA and CST at follow-up visits compared with baseline. At month 3, mean BCVA was improved in all groups. Although the increase in BCVA at month 3 was significant in DRT and CME groups, it was not significant in SRD group (p=0.03, p<0.01, and p=0.22, respectively). At month 12, BCVA significantly improved compared to baseline values in DRT, CME, and SRD groups (p=0.01, p=0.01 and p<0.01, respectively). There was no significant difference between groups in terms of BCVA at baseline and months 3, 6, 12 (p=0.13, p=0.67, p=0.54, and p=0.28, respectively). Mean CST significantly decreased compared to baseline values at the end of month 12 (all p<0.01). Aflibercept therapy provided an improvement in visual acuity and decreased CST in different morphological DME types for one year. The number of injections that could achieve this efficacy was least in DRT group, and more injections were required in SRD group.