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Background: Diabetic retinopathy is a leading cause of blindness worldwide. The aim of this study was to know the effect of duration of diabetes on severity of diabetic retinopathy. Material & Methods: This descriptive study was conducted at District Head Quarter Hospital Karak and Group of Teaching Hospitals Bannu from July 2007 to July 2010. Diabetic patients were divided into three groups in relation to diabetic age. Group A ≤10 years, group B 11-20 years and group C >20 years. Pupils were dilated and fundoscopy performed with direct, indirect ophthalmoscopy and slit lamp indirect bimicroscopy. Results: During the study period, 370 patients were seen with age range 35-80 years. Out of these 205(55.5%)were males and 165(44.5%) females. Eighty-nine (24.1%) patients had type 1 while 281(75.9%) type 2 diabetes mellitus. In group-A 185(86.04%) patients had normal fundi and 24 (11.16%) non-proliferative diabetic retinopathy and proliferative diabetic retinopathy in 6(2.79%). In group-B 39(33.33%) had normal fundi, 46(39.31%) non-proliferative and in 32(27.35%) proliferative diabetic retinopathy. In group-C no patient had normal fundi, 15(39.47%) non-proliferative and 23(60.52%) proliferative diabetic retinopathy. By applying X2 to comparing groups A with B and B with C p value was < 0.05 and A with C p value was < 0.001 showing significant and highly significant results. Conclusion: Severity of diabetic retinopathy increases with increasing duration of diabetes.