Diabetic retinopathy (DR) remains an important cause of blindness in Spain. The prevalence of blindness in diabetic persons ranges from 4% to 11% and is higher than that in other countries (between 1 and 5%). The prevalence of DR in Spain varies in the distinct studies but is approximately 40%, while that of proliferative DR is between 4% and 6% and that of macular edema is between 1.4 % and 7.9%. Routine screening is effective in reducing the incidence of visual loss and blindness. Screening compliance is about 50% in primary care and is over 70% in specialized care. Although there is some evidence that the incidence of DR is decreasing in Europe and the USA, only a few studies have reported the same trend in Spain. Screening of DR with nonmydriatic camera has been supported by several guidelines, since this procedure shows the best cost-effectiveness ratio and is easy to use.