Background: Diabetic retinopathy (DR) is the major cause of vision loss in adults with diabetes mellitus (DM) and the most common micro vascular diabetic complication. Strict glycaemic control and early detection and appropriate management are key to halting disease progression. Aim: investigate type 2 diabetes patient’s awareness and KAP regarding retinopathy in two Middle East countries. Methods: A cross-sectional multinational survey was conducted among all patients agreed to participate and fulfill the inclusion criteria at DM clinics in one Egyptian and one Saudi hospital (400 Egyptians and 394 Saudi patients). Two interview questionnaires were used in data collection. Results: There was statistically significant relationship between the Egyptian and Saudi patients ' knowledge, attitude, and practice (p <0.001).  Significant relationship between patients’ awareness with knowledge and practice (p <0.001), while, no significant relationships were founded between patients’ awareness and attitude. Regarding socio-demographic traits in both studied groups, lower age patients, females, patients have less than 5 years of DM duration, patients have previous family history for DM, patient have good glycemic control all have better KAP in relation to DM and DR. Conclusions: Saudi T2D patients showed better awareness, knowledge, and attitude toward DR.