Background:International Diabetes Federation (IDF) predicts an increase in the number of patients with diabetes to 643 million by 2030 and to 784 million by 2045. Present study was aimed to study occurrence of various grades of diabetic retinopathy in patients with end stage renal disease in a tertiary hospital.Material and Methods: Present study was hospital based, cross‑sectional, observational study, conducted patients of type 2 DM, admitted with end stage renal disease (ESRD) due to diabetic nephropathy, underwent evaluation for diabetic retinopathy. Results: In present study, 56 patients of diabetic ESRD were included. Majority patients had Best-corrected visual acuity (BCVA) as good vision (42.86 %) followed by impaired vision (28.57 %), blind (<3/60) (23.21 %) &legally blind (5.36 %). In present study, incidence of diabetic retinopathy was 60.71 %. Majority had Mild non-proliferative diabetic retinopathy (NPDR) (26.79 %) followed by Moderate non-proliferative diabetic retinopathy (13.39 %), Proliferative diabetic retinopathy (PDR) (11.61 %) & least had Severe non-proliferative diabetic retinopathy (8.93 %). Higher incidence of diabetic retinopathy as well severity of diabetic retinopathy, was noted with increasing age of patients, association was statistically significant (p- 0.022). Higher incidence of diabetic retinopathy as well severity of diabetic retinopathy, was noted with increasing duration of diabetes, association was statistically significant (p- 0.018). Conclusion: The risk of Diabetic retinopathy as well as severity of Diabetic retinopathy increase in age of patient & duration of diabetes in patients of ESRD