The prevalence of diabetic retinopathy is increasing worldwide due to an increasing number, and prolonged survival, of diabetic patients. Many effective treatments for different types and stages of retinopathy exist. However, there is patchy delivery of care, inconsistent screening, and unresolved questions about several management questions. This article discusses the current state of knowledge about therapeutics in diabetic retinopathy, and highlights areas where further studies and evidence base is required.