Purpose: To determine the relationship between the severity or stage of diabetic retinopathy and associated risk factors in a southern Brazilian population. Methods: Transversal study of diabetic patients without previous ophthalmologic treatment, seen at a University eye clinic. These patients underwent fundus photography, complete blood work-up, sys- temic blood pressure measurement, urine analysis, and were questioned about risk factors previously determined by the authors. The presence or absence of risk factors was compared to the severity of diabetic retinopathy. Results: Eighty-one patients were selected, 28 male, 53 female, 55 Cauca- sians, 26 African descendants, 28 had insulin-dependent diabetes mellitus, 53 had non-insulin-dependent diabetes mellitus. Factors related to more severe diabetic retinopathy include: insulin-dependent diabetes mellitus (α<0.01), nephropathy (α<0.05), proteinuria (α<0.05), duration of the disease (p<0.001), elevated fasting plasma glucose (p=0.11), glycosylated hemoglobin (HbA (1c)) (p=0.001), total serum cholesterol (p=0.019), lower hematocrit (p=0.004) and hemoglobin (p=0.001). Conclusions: The severity of diabetic retinopathy appears to be associated with risk factors such as duration of disease, type of diabetes, poor metabolic control, hemoglobin levels, total cholesterol and proteinuria. Factors apparently not related to severity of diabetic retinopathy include gender, age, systemic hypertension and hypomagnesemia. ABSTRACT 1