Aim To investigate the relationship between serum microRNA-29c (miR-29c), basic fibroblast growth factor (bFGF) levels and diabetic retinopathy (DR). Methods 154 patients with type 2 diabetes mellitus (T2DM) were selected and divided into DR group (n=65) and NDR group (n=89) according to whether they had combined retinopathy or not, and another 64 physically healthy people were selected as the control group during the same period. Spearman correlation analysis was used to correlate serum miR-29c with bFGF levels in the DR group. Multi-factor Logistic regression was used to analyze the factors influencing the occurrence of DR. ROC curve was used to analyze the diagnostic value of serum miR-29c and bFGF levels for DR. Results Serum miR-29c and bFGF levels gradually increased in the control group, NDR group and DR group (P＜0.05). Spearman correlation analysis showed that serum miR-29c was positively correlated with bFGF levels in the DR group (r_s=0.593, P＜0.001). Multi-factor Logistic regression analysis showed that disease duration (OR=1.2,5%CI:1.046 to 1.226), glycosylated hemoglobin A1c (HbA1c) (OR=2.1,5%CI:1.499 to 2.725), miR-29c (OR=2.3,5%CI:1.132 to 3.943), and bFGF (OR=3.8,5%CI:1.178 to 5.304) were independent risk factors for DR (P＜0.05). The ROC curves showed that the sensitivity and specificity of miR-29c combined with bFGF for the diagnosis of DR (76.92% and 83.15%) were higher than those of miR-29c alone (64.62% and 78.65%), bFGF (75.38% and 60.67%) diagnosis. Conclusions Serum miR-29c and bFGF levels are significantly elevated in patients with T2DM, which are closely related and jointly involved in retinopathy development. Combined detection of serum miR-29c and bFGF levels can improve the diagnostic efficacy of DR.