This narrative review examines the global epidemiology and screening programs for diabetic retinopathy (DR), a sight-threatening complication of diabetes. The review highlights the increasing prevalence of DR, which is expected to rise with the growing diabetes population. It discusses the effectiveness and limitations of various screening approaches, including the use of 2-4 field fundus images, cell phone-based screening, and individualized screening intervals. The review also explores the role of artificial intelligence (AI) in enhancing screening efficiency and cost-effectiveness. While some countries have established comprehensive national Diabetic Eye Screening Programs (DESPs), many low- and middle-income countries face challenges in implementing effective screening programs due to limited resources and access to trained professionals. The review emphasizes the need for improved screening infrastructure, evidence-based guidelines, and integration of screening with effective treatment strategies to reduce the burden of DR and its complications. The emergence of AI technology is seen as a promising solution to enhance screening accessibility and accuracy, but ethical concerns and robust validation are still necessary. Overall, the review underscores the importance of ongoing efforts to improve DR screening programs globally.This narrative review examines the global epidemiology and screening programs for diabetic retinopathy (DR), a sight-threatening complication of diabetes. The review highlights the increasing prevalence of DR, which is expected to rise with the growing diabetes population. It discusses the effectiveness and limitations of various screening approaches, including the use of 2-4 field fundus images, cell phone-based screening, and individualized screening intervals. The review also explores the role of artificial intelligence (AI) in enhancing screening efficiency and cost-effectiveness. While some countries have established comprehensive national Diabetic Eye Screening Programs (DESPs), many low- and middle-income countries face challenges in implementing effective screening programs due to limited resources and access to trained professionals. The review emphasizes the need for improved screening infrastructure, evidence-based guidelines, and integration of screening with effective treatment strategies to reduce the burden of DR and its complications. The emergence of AI technology is seen as a promising solution to enhance screening accessibility and accuracy, but ethical concerns and robust validation are still necessary. Overall, the review underscores the importance of ongoing efforts to improve DR screening programs globally.