Diabetic retinopathy (DR) is a leading cause of blindness among working-age adults globally, with its prevalence rising alongside the increasing incidence of diabetes. This chapter explores the epidemiology of DR, emphasizing disparities between type 1 and type 2 diabetes, regional variations, and its association with other systemic diabetic complications. It discusses advancements in screening initiatives, including telemedicine and national programs, and highlights the transformative potential of artificial intelligence (AI), particularly deep learning, in enhancing DR detection and cost-effective screening. The chapter also addresses the challenges of implementing AI-based solutions, especially in resource-limited settings.