The identification and quantitation of factors that are associated with the risk of retinopathy in diabetic patients is essential to be identified in different populations. Data exist for the risk factors associated with the prevalence and incidence of diabetic retinopathy in our population is limited. In this study, we assessed the association of risk factors including hyperhomocysteinemia with retinopathy in Iranian patients with type 2 diabetes.In a cross-sectional study, the association of biometric and biochemical characteristics of two hundred and fifty four established type 2 diabetic patients with or without retinopathy were investigated. Patients were classified by funduscopic examination and angiographic results into normal, non-proliferative and proliferative retinopathy.Multiple logistic regression analysis showed that the risk of all type of retinopathy was significantly and independently associated with a longer duration of diabetes, hypertension and hyperhomocysteinemia. Subjects with hyperhomocysteinemia had more than 2.7-, 2.5-, and 2.5-fold risk of all type of retinopathy, non-proliferative and proliferative retinopathy, respectively, compared with the subjects with normal plasma tHcy when adjusted for other risk factors.We conclude that longer duration of diabetes, hypertension and hyperhomocysteinemia are independent risk factors associated with retinopathy in type 2 diabetes in our population.