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Background Diabetic macular oedema (DME) is the most common causes of vision loss in diabetics. Despite the fact that the global prevalence of DME is growing, no studies on the burden and risk factors of diabetic macular edema have been conducted in Ethiopia. The goal of this research was to look into the magnitude of diabetic macular edema and its associated factors among diabetic patients at Debre Markos Referral Hospital, North-West Ethiopia, 2021. Methods A cross-sectional study with 426 participants was done. They were obtained using a systematic sampling method. The explanatory data was collected from a review the medical records. The subjects' blood pressure, weight, height, and visual acuity were already assessed. Optical coherence tomography has been used to evaluate the funds. For analysis, data was entered into epi-data 3.1 versions and exported to the Statistical Package for Social Science (SPSS version 25) program. For factor analyses, binary logistic regression with a 95% confidence level was used. Result Diabetic macular edema was diagnosed in 26.3% of the 426 individuals. There's none- clinically significant macula oedema in 84 (75%) of them. Visual acuity had been a problem for half of diabetic patients (43.4%). Macular edema was strongly associated with poor glycemic management (AOR (95% CI: 2.97 (1.86,9.76)), hypertension (AOR (95% CI: 2.55 (1.64,6.12)), and longer diabetic duration (AOR ( 95% CI: 3.15 (1.78,7.52)). Conclusion and recommendation : Macular oedema is ubiquitous in diabetic patients (26.3%). Diabetic macular edema was found to be positively associated with poor glycemic control, being hypertensive, and having a long history of diabetic illness. Routine assessment of funds, early treatment, health promotion, and early control of risk factors may all be critical in lowering the prevalence and impact of diabetic macular edema.

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