Background: The incidence of diabetes mellitus is rapidly increasing, and it frequently causes considerable metabolic disorders and serious consequences. MicroRNA-200b (miR-200b) is a regulator of angiogenesis that has emerged as a diagnostic and predictive tool for certain disorders. Aim: to investigate the association of miR-200b with diabetic retinopathy (DR). Methods: The study included 100 subjects from Benha University Hospital: 40 patients with type 2 diabetes (T2D) without DR, 40 with T2D and DR, and 20 healthy controls. MicroRNA-200b was assessed for all subjects using real time PCR with SYBR Green. Results: Diabetics had lower levels of miR-200b than healthy controls. While, those without DR had even lower miR-200b levels compared to those who did have DR. Additionally, lower miR-200b levels were associated with neuropathy but not with nephropathy. Conclusion: MiR-200b showed promise as a biomarker for both T2D and DR. It perfectly differentiated diabetic patients with and without retinopathy, while offering moderate accuracy for diagnosing diabetes in general. These findings suggest miR-200b may play a risky role in DR among diabetics, and further research is warranted to confirm these results.