〔Abstract〕 Objective To analyze the prevalence of diabetic retinopathy (DR) and related risk factors in hospitalized patients with diabetes mellitus (DM). Methods A total of 122 DM patients who were treated at Luohe Central Hospital from January 2021 to August 2023 were selected. According to fundus symptoms, the patients were divided into the non-DR group (56 cases) and the DR group (66 cases). The DR group was further divided into the non-proliferative diabetic retinopathy (NPDR) group (41 cases) and the proliferative diabetic retinopathy (PDR) group (25 cases). The relevant clinical data of 122 patients were collected, and logistic regression analysis was used to analyze the factors influencing the occurrence of DR and PDR. Results (1) Compared with the non-DR group, patients in the DR group were generally older, had a longer course of disease, higher glycosylated hemoglobin (HbA1c) levels, and a higher proportion of patients with hypertension and hyperlipidemia, with statistically significant differences (P < 0.05); (2) Patients in the PDR group generally had a longer course of disease and higher body mass index (BMI) levels than patients in the NPDR group, and a higher proportion of patients with hyperlipidemia, with statistically significant differences (P < 0.05). (3) The results of multivariate logistic regression analysis showed that a longer course of disease and higher HbA1c levels were risk factors for the occurrence of DR in DM patients (P < 0.05); A longer course of disease and comorbid hyperlipidemia were risk factors for the occurrence of PDR in DR patients (P < 0.05). Conclusion A longer course of disease and higher HbA1c levels are independent risk factors for the occurrence of DR in DM patients. For patients who have already developed DR, a longer course of disease and comorbid hyperlipidemia are independent risk factors for the progression to PDR.