To explore the predictive efficacy of the triglyceride glucose (TyG) index and systemic immune inflammation index (SII) levels for diabetic retinopathy (DR) in patients with Type-2 diabetes mellitus (T2DM).A retrospective study was conducted on 200 T2DM patients admitted to the Ophthalmology Department at Baoding No.1 Central Hospital from June 2023 to December 2023. The patients were divided into 80 none-DR, 120 with DR. General information, biochemical tests, TyG index, and SII were collected. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive ability of TyG index and SII for DR. Binary logistic regression was employed to assess the relationship between DR occurrence and TyG index and SII.The mean TyG index and SII levels were higher in the DR group compared to none-DR group (P<0.05). The ROC curve analysis indicated that the combination of TyG index and SII had the highest area under the curve (AUC) at 0.912, surpassing the AUC of TyG index and SII individually. Binary logistic regression analysis demonstrated that TyG index and SII were independent predictors of DR occurrence in diabetic patients (OR=1.745, 95%CI: 1.213-2.547, P<0.05; OR=1.347, 95%CI: 1.115-1.843, P<0.05, respectively).TyG index and SII levels may predict the occurrence of DR in T2DM patients, and the combination of these two indices offers the best predictive efficacy for DR.Copyright: © Pakistan Journal of Medical Sciences.