Diabetic retinopathy (DR) is a major microvascular complication of type 2 diabetes mellitus (T2DM) and a leading cause of vision loss globally. Vascular Endothelial Growth Factor (VEGF) plays a critical role in angiogenesis and increased vascular permeability, key processes in the pathogenesis of DR. Recent studies have explored the association of VEGF gene polymorphisms with susceptibility to DR in T2DM patients. This review aims to summarize and analyze the current evidence regarding the association of VEGF gene polymorphisms, particularly single nucleotide polymorphisms (SNPs), with the development and progression of DR in individuals with T2DM. A comprehensive literature search was conducted to identify relevant studies investigating VEGF gene variants and their correlation with DR. Key polymorphisms, such as VEGF -2578C/A, -460T/C, +405G/C, and others, were evaluated for their potential role in genetic predisposition to DR. The findings highlight that certain VEGF gene polymorphisms are significantly associated with increased risk of DR in various populations. Differences in allelic frequency and genotype distributions among ethnic groups are also evident, indicating a complex interplay of genetic and environmental factors. Conclusion: VEGF gene polymorphisms may serve as potential genetic markers for predicting DR risk in T2DM patients. Understanding these associations could facilitate early detection, personalized risk assessment, and the development of targeted therapies. However, further large-scale and multi-ethnic studies are warranted to validate these findings and elucidate underlying molecular mechanisms.