Abstract: Objective We aimed to examine the clinical and pathological association between diabetic retinopathy(DR) and diabetic kidney disease(DKD) in type 2 diabetes mellitus(T2DM) population,and discuss histopathologically.Methods A total of 70 patients with T2DM and biopsy-proven DKD and complete DR were selected to conduct a cross-sectional study of their clinicopathological data.Results The differences between DR group and systolic blood pressure,hemoglobin,albumin,24-hour urinary protein and acute kidney injury were statistically significant(P<0.01).The DR group was positively correlated with the DKD pathological grading(r=0.486) and Kimmelstiel-Wilson lesion(r=0.408) (P<0.01).Diabetic macular edema was positively correlated with arteriolar hyalinosis(r=0.351) and microhemangioma(r=0.341) (P<0.01).Conclusions It is possible to assess the clinical and pathological changes in DKD by the severity of DR.